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Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials
Author(s) -
Straka Christian,
Knop Stefan,
Vogel Martin,
Müller Jürgen,
Kropff Martin,
Metzner Bernd,
Langer Christian,
Sayer Herbert,
Jung Wolfram,
Dürk Heinz A.,
Salwender Hans,
Wandt Hannes,
Bassermann Florian,
Gramatzki Martin,
Rösler Wolf,
Wolf HansHeinrich,
Brugger Wolfram,
Fischer Thomas,
Liebisch Peter,
Engelhardt Monika,
Einsele Hermann
Publication year - 2019
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13281
Subject(s) - bortezomib , medicine , multiple myeloma , consolidation (business) , autologous stem cell transplantation , clinical trial , surgery , oncology , accounting , business
Objective A post hoc analysis of two phase III trials was carried out to explore the influence of age and treatment factors on the effect of bortezomib consolidation on progression‐free survival (PFS) post autologous stem cell transplantation (ASCT). Methods Patients with newly diagnosed multiple myeloma were assigned to one of two trials (ClinicalTrials.gov IDs: NCT00416273, NCT00416208), which were conducted in parallel, based on age (18‐60 or 61‐75 years, respectively). Following induction and ASCT, patients were randomized 1:1 to four 35‐day cycles of bortezomib consolidation (1.6 mg/m 2 IV on days 1, 8, 15, 22) or observation only. Results Median PFS with bortezomib consolidation vs observation was 33.6 vs 29.0 months ( P = 0.3599) in patients aged 18‐60 years (n = 202), and 33.4 vs 26.4 months ( P = 0.0073) in patients aged 61‐75 years (n = 155), respectively. Bortezomib consolidation post‐ASCT appeared to equalize outcomes between older and younger patients who received prior treatment of differing intensity. This suggests that the effect of consolidation may be relative and may depend on the composition and intensity of induction and high‐dose therapy. Conclusion Older patients receiving less intensive prior treatment could experience a larger PFS benefit from bortezomib consolidation.