Bortezomib and thalidomide treatment results in newly diagnosed transplant-ineligible multiple myeloma patients are comparable in long-term follow-up

Abstract

Background: Thalidomide-and bortezomib-containing regimens are widely used for transplant-ineligible newly diagnosed multiple myeloma patients. The aim of this study was to analyse the efficiency of thalidomide-or bortezomib-based regimens in long-term follow-up. Materials and methods: From 2008 to 2012, 142 transplant-ineligible newly dia gnosed multiple myeloma patients were analysed retrospectively. Bortezomib was administered at the standard dos ing of 1.3 mg/m2 weekly, and thalidomide was administered at a daily dose of 100 mg. Both drugs were combined with cyclophosphamide and dexamethasone. A total of 95 patients were treated with thalidomide and 47 with bortezomib. A median four cycles of treatment were administered in both groups. Results: In the thalidomide group, the over all response rate was 60.6%, the median progression-free survival (PFS) was 10.3 months (95% CI 7.4-13.2) and the median over all survival (OS) was 35.1 months (95% CI 23.9-46.3). In the bortezomib group, the over all response rate was 51.1%, the median PFS was 11.9 months (95% CI 8.8-15) and the median OS was 25.4 months (95% CI 9.3-41.6). There was a statistically significant difference in OS (p = 0.027), favour ing the cyclophosphamide/thalidomide/dexamethasone group, but the response rates and PFS intervals were not significantly different between both groups. The median follow-up in the thalidomide group was 35.1 months (95% CI 0.2-95.9) compared to 25.1 months (95% CI 0.4-60.6) in the bortezomib group (p = 0.004). The incidence of serious adverse events was comparable in both groups. Conclusion: In conclusion, the results of bortezomib treatment are comparable to thalidomide treatment under conditions of short administration. According to other clinical trials, long-term bortezomib treatment provides an additional advantage for PFS and OS.