Back to Search Start Over

Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients: A retrospective case-matched study

Authors :
Pierre W. Wijermans
Pieter Sonneveld
Mario Boccadoro
Massimo Offidani
Alessandra Larocca
Jesús F. San Miguel
Valeria Magarotto
Meral Beksac
Gunnar Juliusson
Chiara Cerrato
Paola Omedè
Maria-Victoria Mateos
Pellegrino Musto
Antonio Palumbo
Anna Marina Liberati
Albert Oriol
Michele Cavo
Daniela Gottardi
Massimo Gentile
Sara Bringhen
Carla Mazzone
Fortunato Morabito
Davide Rossi
Ana Isabel Turel
Maide Cavalli
Peter Gimsing
Martijn R. Schaafsma
Roberto Passera
Sonja Zweegman
Anders Waage
Lucio Catalano
Juan José Lahuerta
Stefano Rosso
Renato Zambello
Source :
American Journal of Hematology. 89:355-362
Publication Year :
2014
Publisher :
Wiley, 2014.

Abstract

Novel agents in combination with melphalan and prednisone (MP) significantly improved progression-free survival (PFS) and overall survival (OS) in multiple myeloma (MM). Randomized trials comparing MP plus bortezomib (VMP) versus MP plus thalidomide (MPT) are lacking. Nine hundred and fifty-six elderly (>65 years) newly diagnosed MM patients from six European randomized trials were retrospectively analyzed and matched for age, albumin, and beta2-microglobulin at diagnosis, 296 patients were selected from the VMP groups, and 294 from MPT. Complete response rate was 21% in the VMP patients and 13% in the MPT patients (P = 0.007). After a median follow-up of 34 months (range, 1-92), VMP significantly prolonged both PFS (median 32.5 vs. 22.9 months, HR 0.65; 95% CI 0.52-0.82; P < 0.001) and OS (median 79.7 vs. 45.1 months, HR 0.44; 95% CI 0.32-0.59; P < 0.001) in comparison with MPT. The benefit in terms of OS of the VMP group was quite similar among patients with different risk factors defined by sex, ISS, ECOG performance status, or serum creatinine but not among patients ≥ 75 years. Multivariate analysis confirmed that VMP was an independent predictor of longer PFS and OS. In a control-case matched analysis, PFS and OS were prolonged in patients who received VMP in comparison with those treated with MPT.

Details

ISSN :
03618609
Volume :
89
Database :
OpenAIRE
Journal :
American Journal of Hematology
Accession number :
edsair.doi...........fb1d8f4554a14ca522f4675d555de3e7
Full Text :
https://doi.org/10.1002/ajh.23641