Author(s): Sonneveld P, Schmidt-Wolf IG, van der Holt B, El Jarari L, Bertsch U, et al.
Purpose: We investigated whether bortezomib during induction and maintenance improves survival in newly diagnosed multiple myeloma (MM).
Patients and methods: In all, 827 eligible patients with newly diagnosed symptomatic MM were randomly assigned to receive induction therapy with vincristine, doxorubicin, and dexamethasone (VAD) or bortezomib, doxorubicin, and dexamethasone (PAD) followed by high-dose melphalan and autologous stem-cell transplantation. Maintenance consisted of thalidomide 50 mg (VAD) once per day or bortezomib 1.3 mg/m(2) (PAD) once every 2 weeks for 2 years. The primary analysis was progression-free survival (PFS) adjusted for International Staging System (ISS) stage.
Results: Complete response (CR), including near CR, was superior after PAD induction (15% v 31%; P < .001) and bortezomib maintenance (34% v 49%; P < .001). After a median follow-up of 41 months, PFS was superior in the PAD arm (median of 28 months v 35 months; hazard ratio [HR], 0.75; 95% CI, 0.62 to 0.90; P = .002). In multivariate analysis, overall survival (OS) was better in the PAD arm (HR, 0.77; 95% CI, 0.60 to 1.00; P = .049). In high-risk patients presenting with increased creatinine more than 2 mg/dL, bortezomib significantly improved PFS from a median of 13 months to 30 months (HR, 0.45; 95% CI, 0.26 to 0.78; P = .004) and OS from a median of 21 months to 54 months (HR, 0.33; 95% CI, 0.16 to 0.65; P < .001). A benefit was also observed in patients with deletion 17p13 (median PFS, 12 v 22 months; HR, 0.47; 95% CI, 0.26 to 0.86; P = .01; median OS, 24 months v not reached at 54 months; HR, 0.36; 95% CI, 0.18 to 0.74; P = .003).
Conclusion: Bortezomib during induction and maintenance improves CR and achieves superior PFS and OS.
Referred From: https://www.ncbi.nlm.nih.gov/pubmed/22802322
Author(s): DimopoulosMA, Kiamouris C, Moulopoulos LA
Author(s): Dimopoulos MA, Moulopoulos LA, Maniatis A, Alexanian R
Author(s): Hu K, Yahalom J
Author(s): Yuranga W, Bruno DM
Author(s): http://www
Author(s): Nofsinger YC, Mirza N, Rowan PT, Lanza D, Weinstein G
Author(s): Losa M, Terreni MR, Tresoldi M, Marcatti M, Campi A, et al.
Author(s): Jagadeesan J, Oudit D, Hardwicke J, Shariff Z, McCoubrey G, et al.
Author(s): Sinnott BP, Hatipoglu B, Sarne DH
Author(s): Elias HG, Scott J, Metheny L, Quereshy FA
Author(s): Pingali SR, Haddad RY, Saad A
Author(s): Campo E, Swedlow SH, Harris NL, Pileri S, Stein H, et al.
Author(s): Ozsahin M, Tsang RW, Poortmans P, Belkacemi Y, Bolla M,et al.
Author(s): Yang B, Yu RL, Chi XH, Lu XC