5 research outputs found
Real-life experience with bortezomib-based regimens in elderly comorbid patients with newly diagnosed multiple myeloma : Polish retrospective multicenter analysis
Bortezomib was the first proteasome inhibitor approved for the therapy of multiple
myeloma (MM). Currently, VMP (bortezomib, melphalan, prednisone) is one of the standard regimens
recommended as the first‑line
therapy for patients with MM ineligible for high‑dose
chemotherapy (HDT)
with autologous stem‑cell
transplantation (auto‑SCT). Participants of clinical trials are highly selected populations; therefore, the aim of this study
was to present observations from real practice that might provide important information for practitioners. We retrospectively analyzed the data on the efficacy and safety of bortezomib‑based
regimens in 154 patients with newly diagnosed MM ineligible for HDT with auto‑SCT
(median
age, 73 years; range, 39-89 years) with particular attention to the effect of age, performance status,
and concomitant diseases. Patients aged 75 years or older constituted 53.2% of the study cohort. Performance status was
impaired in 34.4% of the patients, according to the Eastern Cooperative Oncology Group scale. Comorbidities
were reported in 83.8% of the patients (mainly arterial hypertension and atherosclerotic vascular
disease). A total of 798 courses of bortezomib‑based
regimens (mainly VMP, 86%) were administered.
The overall response rate was 81.7%, including 12.7% for complete response and 29.6% for very good
partial response. The median progression‑free
survival (PFS) and event‑free
survival were 17.3 and 7.1
months, respectively. The impaired performance status and age of 75 or older were negative predictors
of PFS. The most common severe adverse events were neuropathy (19.4%), infections (19.2%), and
neutropenia (14.9%). Bortezomib‑based
regimens are effective and well tolerated in the first‑line
therapy of
elderly patients with MM and comorbidities, with advanced disease, and light chain MM. A more detailed
assessment of patients' frailty is needed to increase the efficacy of treatment