Newly diagnosed multiple myeloma cases have shown improved progression-free survival (PFS), maintenance complete response, and overall survival (OS) rates with induction treatment using combination of bortezomib, doxorubicin, and dexamethasone, in a study published in the Journal of Clinical Oncology.
The randomized Phase 3 trial involved,
- 827 patients with newly diagnosed, symptomatic MM.
- Patients were randomly assigned for induction therapy with either vincristine, doxorubicin, and dexamethasone (VAD) or bortezomib, doxorubicin, and dexamethasone (PAD).
- Followed by high dose melphalan and autologous stem-cell transplantation.
- People in VAD received thalidomide 50mg once/day as maintenance therapy.
- And bortezomib 1.3 mg/m2 once in 2 weeks for 2 years was administered in PAD as maintenance.
- Primary analysis was PFS.
- Results of the study are as follows,
- PAD induction provided significantly superior complete responses when compared to VAD.
- Bortezomib maintenance therapy improved complete response rates (CR).
- Patients on PAD showed improved PFS when compared to those on VAD.
- Induction and maintenance therapy by bortezomib showed greater benefits in high-risk patients.
Thus, the study authors conclude that induction and maintenance therapy using bortezomib show better response, quality of response, progression-free survival, and overall survival rates.
Dr. Laurent Garderet of Hospital Saint Antoine, Paris, France and lead investigator of study, recommends VTD with appropriate dosages and route, in Myeloma Beacon.
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