Bortezomib and thalidomide treatment results in newly diagnosed transplant ineligible multiple myeloma patients are comparable in long term follow up

Martin Štork, Viera Sandecká, Ivanna Boichuk, Zdeněk Adam, Marta Krejčí, Lucie Brožová, Sabina Ševčíková, Luděk Pour


Thalidomide and bortezomib containing regiments are widely used for transplant ineligible newly diagnosed multiple myeloma patients. The aim of this study was to analyze efficiency of thalidomide or bortezomib based regimens in long term follow up.

From 2008 to 2012, 142 transplant ineligible newly diagnosed multiple myeloma patients were retrospectively analyzed.  
Bortezomib was administered at the standard dosing of 1.3mg/m2 weekly, and thalidomide was administered at daily dose of 100mg. Both drugs were combined with cyclophosphamide and dexamethasone. Ninety-five patients were treated with thalidomide and 47 with bortezomib. Median 4 cycles of treatment were administered in both groups.
In the thalidomide group, overall response rate was 60.6 %, median progression-free survival (PFS) was 10.3 months (95% CI: 7.4–13.2) and median overall survival (OS) was 35.1 months (95% CI: 23.9–46.3). In the bortezomib group, overall response rate was 51.1 %, median PFS was 11.9 months (95% CI: 8.8–15), and median OS was 25.4 months (95% CI: 9.3–41.6).  There was a statistically significant difference in OS (P=0.027), favoring CTD group, but response rates and PFS intervals were not significantly different between both groups. Median follow-up in the thalidomide group was 35.1 months (95% CI: 0.2-95.9) compared to 25.1 months (95% CI: 0.4-60.6) in the bortezomib group (P=0.004). Incidence of serious adverse events was comparable in both groups.
In conclusion, results of bortezomib treatment are comparable to thalidomide treatment in conditions of short administration. For better results, long-term bortezomib treatment is necessary.

Key words: Bortezomib, thalidomide, multiple myeloma, primotherapy

Klíčová slova

Bortezomib, thalidomid, mnohočetný myelom, primoterapie

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