Objective: To evaluate the efficacy and safety of bortezomib retreatment in 76 patients with relapsed/refractory multiple myeloma (MM), who previously responded to bortezomib.
Methods: Retrospective analysis of 76 MM patients, who had achieved at least a partial response (PR) on initial bortezomib therapy in our hospital from May 2006 to August 2011, received bortezomib retreatment when they relapsed or progressed.
Results: The overall response rate (ORR) was 60.5%, among them 6.5% patients achieved CR, 5.8% patients achieved very good partial response (VGPR), 38.2% patients achieved PR. Then we further stratified all patients into 3 groups according to the response of initial bortezomib therapy, including CR group, VGPR group and PR group. After bortezomib retreatment, the ORR of the 3 groups was 84.6%, 73.1% and 43.2%, respectively. According to the response of bortezomib retreatment, the patients were divided into 2 groups: group 1 who at least achieved PR, group 2 who showed no response. The median progression-free survival (PFS) after bortezomib retreatment for group 1 and 2 was 7(1-39) and 5(1-14) months, respectively (P>0.05), while the median overall survival (OS) after bortezomib retreatment was 16(2-64) and 8(1-28) months, respectively (P<0.05). Adverse events (AE) were identified in 88% patients during bortezomib retreatment, including neutropenia, diarrhea and thrombocytopenia, only 9.2%(7 patients) reached Ⅲ-Ⅳ grade of AE. Severe peripheral neuropathy occurred in only one patient.
Conclusion: Bortezomib retreatment regimen is demonstrated a higher response rate in patients who achieved deeper response in initial treatment, with no more adverse events.
目的 探讨硼替佐米再治疗多发性骨髓瘤（MM）的疗效及安全性。方法 回顾性分析2006年5月至2011年8月收治的76例硼替佐米初次治疗疗效达部分反应（PR）以上，复发或疾病进展后予以硼替佐米再治疗的MM患者，评价硼替佐米再治疗的疗效及不良反应。结果 硼替佐米再治疗MM的总有效率（ORR）为60.5%，其中完全反应（CR）率 6.5%，非常好的部分反应（VGPR）率15.8%，PR率38.2%。按硼替佐米初治后疗效分为CR、VGPR、PR组，3组患者再治疗后ORR分别为84.6%、73.1%和43.2%。按患者硼替佐米再治疗后疗效分成2组，达到PR及以上的为有效组，未达到PR的为无效组，两组自硼替佐米再治疗后中位疾病无进展生存期分别为7（1~39）个月和5（1~14）个月（P>0.05）；中位总生存期分别为16（2~64）个月和8（1~28）个月（P<0.05）。88.2%的患者硼替佐米再治疗时出现不同程度的不良反应，其中仅9.2%（7例）患者为Ⅲ~Ⅳ级，主要为中性粒细胞减少、腹泻和血小板减少，仅1例发生严重的周围神经病变。结论 硼替佐米初治疗效好的MM患者，再予以硼替佐米治疗反应率高，不良反应发生率较前无明显增加。