A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalanprednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma

Min Kyoung Kim, Kihyun Kim, Chang Ki Min, Jae Yong Kwak, Sang Byung Bae, Sung Soo Yoon, Je Jung Lee, Ki Hwan Kim, Seung Hyun Nam, Yeung Chul Mun, Hyo Jung Kim, Sung Hwa Bae, Ho Jin Shin, Jung Hee Lee, Joon Seong Park, Seong Hyun Jeong, Mark Hong Lee, Yang Soo Kim, Ho Sup Lee, Keon Woo ParkWon Sik Lee, Sang Min Lee, Jeong Ok Lee, Myung Soo Hyun, Deog Yeon Jo, Sung Nam Lim, Jae Hoon Lee, Do Yeun Cho, Young Rok Do, Jeong A. Kim, Seong Kyu Park, Jin Seok Kim, Soo Jeong Kim, Hawk Kim, Hyeon Gyu Yi, Joon Ho Moon, Chul Won Choi, Sung Hyun Kim, Young Don Joo, Hoon Gu Kim, Byung Soo Kim, Moo Rim Park, Moo Kon Song, Su Youn Kim

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3 Citations (Scopus)

Abstract

Bortezomib-melphalan-prednisone (VMP) showed superior efficacy versus MP as first-line treatment for transplantation-ineligible multiple myeloma (MM). This study investigated the efficacy of VMP for Korean patients with MM. Overall, 177 MM patients received 9 cycles of VMP in this prospective, multicenter, observational study. The primary endpoint was 2-year progression-free survival (PFS). Thirty-nine (22%) patients were aged ≥ 75 years and 83 (47.4%) patients had International Staging System stage III. A median of 5 cycles were delivered. Overall response rate (ORR) was 72.9%, and complete response (CR) rate was 20.3%. With a median follow-up of 11.9 months, median PFS was 17 months. The 2-year PFS and overall survival (OS) rates were 29.2% and 80.0%, respectively. Median OS was not reached. PFS was significantly different depending on performance status (Eastern Cooperative Oncology Group < 2 vs. ≥ 2; p = 0.0002), β2-microglobulin level (< 5.5 vs. = 5.5 mg/L; p = 0.0481), and cumulative dose of bortezomib (< 35.1 vs. = 35.1 mg/ m2; p < 0001). The common adverse events (AEs) were in line with the well-known toxicity profiles associated with VMP. In conclusion, VMP is a feasible and effective front-line treatment for transplantineligible older patients with MM in Korea. Continuing therapy with prompt adjustment of treatment according to AEs may be important to improve outcomes of elderly patients.

Original languageEnglish
Pages (from-to)37605-37618
Number of pages14
JournalOncotarget
Volume8
Issue number23
DOIs
Publication statusPublished - 2017

Keywords

  • Aged
  • Bortezomib
  • Combination
  • Drug therapy
  • Multiple myeloma

ASJC Scopus subject areas

  • Oncology

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    Kim, M. K., Kim, K., Min, C. K., Kwak, J. Y., Bae, S. B., Yoon, S. S., Lee, J. J., Kim, K. H., Nam, S. H., Mun, Y. C., Kim, H. J., Bae, S. H., Shin, H. J., Lee, J. H., Park, J. S., Jeong, S. H., Lee, M. H., Kim, Y. S., Lee, H. S., ... Kim, S. Y. (2017). A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalanprednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma. Oncotarget, 8(23), 37605-37618. https://doi.org/10.18632/oncotarget.16790