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Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients: A retrospective case‐matched study
Author(s) -
Morabito Fortunato,
Bringhen Sara,
Larocca Alessandra,
Wijermans Pierre,
Victoria Mateos Maria,
Gimsing Peter,
Mazzone Carla,
Gottardi Daniela,
Omedè Paola,
Zweegman Sonja,
José Lahuerta Juan,
Zambello Renato,
Musto Pellegrino,
Magarotto Valeria,
Schaafsma Martijn,
Oriol Albert,
Juliusson Gunnar,
Cerrato Chiara,
Catalano Lucio,
Gentile Massimo,
Isabel Turel Ana,
Marina Liberati Anna,
Cavalli Maide,
Rossi Davide,
Passera Roberto,
Rosso Stefano,
Beksac Meral,
Cavo Michele,
Waage Anders,
San Miguel Jesus,
Boccadoro Mario,
Sonneveld Pieter,
Palumbo Antonio,
Offidani Massimo
Publication year - 2014
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.23641
Subject(s) - melphalan , medicine , prednisone , multiple myeloma , thalidomide , bortezomib , gastroenterology , creatinine , lenalidomide , hazard ratio , surgery , confidence interval
Novel agents in combination with melphalan and prednisone (MP) significantly improved progression‐free survival (PFS) and overall survival (OS) in multiple myeloma (MM). Randomized trials comparing MP plus bortezomib (VMP) versus MP plus thalidomide (MPT) are lacking. Nine hundred and fifty‐six elderly (>65 years) newly diagnosed MM patients from six European randomized trials were retrospectively analyzed and matched for age, albumin, and beta2‐microglobulin at diagnosis, 296 patients were selected from the VMP groups, and 294 from MPT. Complete response rate was 21% in the VMP patients and 13% in the MPT patients ( P = 0.007). After a median follow‐up of 34 months (range, 1–92), VMP significantly prolonged both PFS (median 32.5 vs. 22.9 months, HR 0.65; 95% CI 0.52–0.82; P < 0.001) and OS (median 79.7 vs. 45.1 months, HR 0.44; 95% CI 0.32–0.59; P < 0.001) in comparison with MPT. The benefit in terms of OS of the VMP group was quite similar among patients with different risk factors defined by sex, ISS, ECOG performance status, or serum creatinine but not among patients ≥75 years. Multivariate analysis confirmed that VMP was an independent predictor of longer PFS and OS. In a control‐case matched analysis, PFS and OS were prolonged in patients who received VMP in comparison with those treated with MPT. Am. J. Hematol. 89:355–362, 2014. © 2013 Wiley Periodicals, Inc.