Elderly patients with multiple myeloma who had a planned switched to bortezomib, thalidomide, and dexamethasone (VTD) during frontline treatment with cyclophosphamide, bortezomib, and dexamethasone (CyBorD) appeared to have better survival outcomes than those who only received CyBorD, according to the results of a retrospective analysis of real-world patients. The results were published in the British Journal of Haematology.

The analysis included 155 newly diagnosed multiple myeloma patients from 3 centers in New Zealand. All of the patients were 70 years or older and had received a minimum of 1 cycle of CyBorD. Patients at 1 of the 3 centers were allowed to switch to the VTD combination, and 20 of the 73 patients (27.4%) at that center did switch after a median of 5 cycles of CyBorD (range, 4–6 cycles).

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Only patients who received at least 7 cycles of CyBorD were included in the analysis to assess the effect of switching to VTD on outcomes. In all, 77 patients were included in the analysis: 17 who had a planned switch to VTD in the middle of CyBorD treatment and 60 who were treated only with CyBorD.

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The patients who switched to VTD had response rates similar to patients who did not switch (76.5% vs 73.3%, respectively). The event-free survival was longer for patients who switched to VTD compared with those who did not (25.4 vs 20.3 months, respectively; P =.028), but the difference in overall survival between the groups was not statistically significant (not reached vs 49.8 months, respectively; P =.277).

“This is the largest real-world dataset on the efficacy of CyBorD in the elderly population,” the study authors wrote. “[A] preplanned switch to VTD was associated with better outcomes.”


Chan H, Chai K, Shih S, et al. Frontline treatment of elderly non transplant-eligible multiple myeloma patients using CyBorD with or without thalidomide-based consolidation: a retrospective multi-centre analysis of real-world data [published online July 12, 2019]. Br J Haematol. doi: 10.1111/bjh.16095