Bortezomib-based therapy for newly diagnosed multiple myeloma patients ineligible for autologous stem cell transplantation: Czech Registry Data

Authors	SANDECKÁ Viera POUR Luděk SPICKA Ivan MINARIK Jiri RADOCHA Jakub JELINEK Tomas HEINDORFER Adriana PAVLICEK Petr SYKORA Michal JUNGOVA Alexandra KESSLER Petr WROBEL Marek STAROSTKA David ULLRYCHOVA Jana STEJSKAL Lukas ŠTORK Martin STRAUB Jan PIKA Tomas KUBÍNOVÁ Lucie ŠEVČÍKOVÁ Sabina MAISNAR Vladimir HAJEK Roman
Year of publication	2021
Type	Article in Periodical
Magazine / Source	European Journal of Haematology
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://onlinelibrary.wiley.com/doi/10.1111/ejh.13683
Doi	http://dx.doi.org/10.1111/ejh.13683
Keywords	bortezomib; multiple myeloma; patient; treatment
Description	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.