Bortezomib and dexamethasone as salvage therapy in patients with relapsed/refractory multiple myeloma: analysis of long-term clinical outcomes

Ann Hematol. 2014 Jan;93(1):123-8. doi: 10.1007/s00277-013-1828-8. Epub 2013 Jul 18.

Abstract

Bortezomib (bort)-dexamethasone (dex) is an effective therapy for relapsed/refractory (R/R) multiple myeloma (MM). This retrospective study investigated the combination of bort (1.3 mg/m(2) on days 1, 4, 8, and 11 every 3 weeks) and dex (20 mg on the day of and the day after bort) as salvage treatment in 85 patients with R/R MM after prior autologous stem cell transplantation or conventional chemotherapy. The median number of prior lines of therapy was 2. Eighty-seven percent of the patients had received immunomodulatory drugs included in some line of therapy before bort-dex. The median number of bort-dex cycles was 6, up to a maximum of 12 cycles. On an intention-to-treat basis, 55 % of the patients achieved at least partial response, including 19 % CR and 35 % achieved at least very good partial response. Median durations of response, time to next therapy and treatment-free interval were 8, 11.2, and 5.1 months, respectively. The most relevant adverse event was peripheral neuropathy, which occurred in 78 % of the patients (grade II, 38 %; grade III, 21 %) and led to treatment discontinuation in 6 %. With a median follow up of 22 months, median time to progression, progression-free survival (PFS) and overall survival (OS) were 8.9, 8.7, and 22 months, respectively. Prolonged PFS and OS were observed in patients achieving CR and receiving bort-dex a single line of prior therapy. Bort-dex was an effective salvage treatment for MM patients, particularly for those in first relapse.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Boronic Acids / administration & dosage
  • Boronic Acids / adverse effects
  • Bortezomib
  • Combined Modality Therapy
  • Dexamethasone / administration & dosage
  • Dexamethasone / adverse effects
  • Drug Evaluation
  • Female
  • Follow-Up Studies
  • Gastrointestinal Diseases / chemically induced
  • Humans
  • Immunologic Factors / administration & dosage
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / surgery
  • Peripheral Nervous System Diseases / chemically induced
  • Proteasome Inhibitors / administration & dosage
  • Proteasome Inhibitors / adverse effects
  • Pyrazines / administration & dosage
  • Pyrazines / adverse effects
  • Recurrence
  • Remission Induction
  • Retrospective Studies
  • Salvage Therapy
  • Thrombocytopenia / chemically induced
  • Treatment Outcome

Substances

  • Boronic Acids
  • Immunologic Factors
  • Proteasome Inhibitors
  • Pyrazines
  • Bortezomib
  • Dexamethasone