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

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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. Am. J. Hematol. 89:355-362, 2014. (c) 2013 Wiley Periodicals, Inc.

Details

Authors
  • Fortunato Morabito
  • Sara Bringhen
  • Alessandra Larocca
  • Pierre Wijermans
  • Maria Victoria Mateos
  • Peter Gimsing
  • Carla Mazzone
  • Daniela Gottardi
  • Paola Omede
  • Sonja Zweegman
  • Juan Jose Lahuerta
  • Renato Zambello
  • Pellegrino Musto
  • Valeria Magarotto
  • Martijn Schaafsma
  • Albert Oriol
  • Chiara Cerrato
  • Lucio Catalano
  • Massimo Gentile
  • Ana Isabel Turel
  • Anna Marina Liberati
  • Maide Cavalli
  • Davide Rossi
  • Roberto Passera
  • Stefano Rosso
  • Meral Beksac
  • Michele Cavo
  • Anders Waage
  • Jesus San Miguel
  • Mario Boccadoro
  • Pieter Sonneveld
  • Antonio Palumbo
  • Massimo Offidani
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Hematology
Original languageEnglish
Pages (from-to)355-362
JournalAmerican Journal of Hematology
Volume89
Issue number4
Publication statusPublished - 2014
Publication categoryResearch
Peer-reviewedYes