Eur J Haematol. 2021 Jul 17. doi: 10.1111/ejh.13683. Online ahead of print.
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); 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 months, (p=0.275), respectively and median OS was 49 vs. 41.7 vs. 37.9 vs. 32.2 months (p=0.004), 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.