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Bortezomib‐based therapy for newly diagnosed multiple myeloma patients ineligible for autologous stem cell transplantation: Czech Registry Data
Author(s) -
Sandecká Viera,
Pour Luděk,
Špička Ivan,
Minařík Jiří,
Radocha Jakub,
Jelínek Tomáš,
Heindorfer Adriana,
Pavlíček Petr,
Sýkora Michal,
Jungová Alexandra,
Kessler Petr,
Wróbel Marek,
Starostka David,
Ullrychová Jana,
Stejskal Lukáš,
Štork Martin,
Straub Jan,
Pika Tomáš,
Brožová Lucie,
Ševčíková Sabina,
Maisnar Vladimír,
Hájek Roman
Publication year - 2021
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.13683
Subject(s) - bortezomib , medicine , multiple myeloma , regimen , melphalan , autologous stem cell transplantation , dexamethasone , thalidomide , lenalidomide , transplantation , cyclophosphamide , oncology , surgery , gastroenterology , chemotherapy
Objectives This study compared the use of bortezomib in different combination regimens in newly diagnosed multiple myeloma (NDMM) patients who were transplant ineligible. Patients and Methods We analyzed data from the Registry of Monoclonal Gammopathies (RMG) of the Czech Myeloma Group (CMG) to provide real‐world evidence of outcome for 794 newly diagnosed MM transplant ineligible patients. The most frequently used regimen was VCd (bortezomib‐cyclophosphamide‐dexamethasone) (47.5%) over VMP (bortezomib‐melphalan‐prednisone) (21.7%), BDd (bortezomib‐doxorubicin‐dexamethasone) (9.8%), and VTd (bortezomib‐thalidomide‐dexamethasone) (2.9%). Results The overall response rate (ORR) was 69.2% (478/691), including 12.6% (≥ CR); 34.7% very good partial responses (VGPR); and 21.9% partial responses (PR). Among triplet regimens, VMP was the most effective regimen compared to VCd, BDd, and VTd. Median PFS was 22.3 vs. 18.5 vs. 13.7 vs. 13.8 mo, ( P = .275), respectively, and median OS was 49 vs. 41.7 vs. 37.9 vs. 32.2 mo ( P = .004), respectively. The most common grade 3‐4 toxicities were anemia in 17.4% and infections in 18% of patients. Conclusion Our study confirmed that bortezomib‐based treatment is effective and safe in NDMM transplant ineligible patients, especially VMP, which was identified as superior between bortezomib‐based induction regimens not only in clinical trials, but also in real clinical practice.