VCD Regimen Preferable as Induction for Newly Diagnosed Multiple Myeloma

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Bortezomib, cyclophosphamide, and dexamethasone (VCD) is preferable to bortezomib, doxorubicin, and dexamethasone (PAd) as induction therapy for transplant-eligible patients with newly diagnosed multiple myeloma, a study published in the journal Leukemia has shown.

For the phase III trial, researchers enrolled 504 patients with newly diagnosed multiple myeloma who were eligible for stem cell transplantation. Patients either received VCD or PAd.

Results showed that 37.0% of patients in the VCD group achieved a very good partial response or better compared with 34.3% of patients in the PAd group (P = 0.001). In addition, 0.4% and 4.8% of those that received VCD and PAd, respectively, had progressive disease.

In regard to safety, serious overall adverse events and those related to thromboembolic events occurred more frequently in the PAd cohort (32.7% vs 24.0%; P = 0.04 and 2.8% vs 0.4%; P = 0.04). Neuropathy also occurred more frequently in the PAd group, while leukocytopenia and neutropenia occurred more commonly in the VCD arm.

The findings suggest that VCD is as effective as PAd and has a more favorable toxicity profile.

The fact that a tumor’s response to a PI3K inhibitor cannot be predicted has led to myriad clinical
Bortezomib, cyclophosphamide, and dexamethasone is preferable as induction therapy for newly diagnosed multiple myeloma.
We aimed at demonstrating non-inferiority of bortezomib/cyclophosphamide/dexamethasone (VCD) compared to bortezomib/doxorubicin/dexamethasone (PAd) induction therapy.

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