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A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalan-prednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma

Authors
Kim, Min KyoungKim, KihyunMin, Chang-KiKwak, Jae-YongBae, Sang-ByungYoon, Sung-SooLee, Je-JungKim, Ki HwanNam, Seung-HyunMun, Yeung-ChulKim, Hyo JungBae, Sung HwaShin, Ho-JinLee, Jung-HeePark, Joon SeongJeong, Seong HyunLee, Mark HongKim, Yang-SooLee, Ho SupPark, Keon WooLee, Won-SikLee, Sang MinLee, Jeong-OkHyun, Myung SooJo, Deog YeonLim, Sung-NamLee, Jae HoonCho, Do-YeunDo, Young RokKim, Jeong-APark, Seong KyuKim, Jin SeokKim, Soo-JeongKim, HawkYi, Hyeon GyuMoon, Joon HoChoi, Chul WonKim, Sung-HyunJoo, Young-DonKim, Hoon-GuKim, Byung SooPark, Moo-RimSong, Moo-KonKim, Su-Youn
Issue Date
6-6월-2017
Publisher
IMPACT JOURNALS LLC
Keywords
multiple myeloma; aged; bortezomib; drug therapy; combination
Citation
ONCOTARGET, v.8, no.23, pp.37605 - 37618
Indexed
SCIE
SCOPUS
Journal Title
ONCOTARGET
Volume
8
Number
23
Start Page
37605
End Page
37618
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/83159
DOI
10.18632/oncotarget.16790
ISSN
1949-2553
Abstract
Bortezomib-melphalan-prednisone (VMP) showed superior efficacy versus MP as first-line treatment for transplantation-ineligible multiple myeloma (MM). This study investigated the efficacy of VMP for Korean patients with MM. Overall, 177 MM patients received 9 cycles of VMP in this prospective, multicenter, observational study. The primary endpoint was 2-year progression-free survival (PFS). Thirty-nine (22%) patients were aged >= 75 years and 83 (47.4%) patients had International Staging System stage III. A median of 5 cycles were delivered. Overall response rate (ORR) was 72.9%, and complete response (CR) rate was 20.3%. With a median follow-up of 11.9 months, median PFS was 17 months. The 2-year PFS and overall survival (OS) rates were 29.2% and 80.0%, respectively. Median OS was not reached. PFS was significantly different depending on performance status (Eastern Cooperative Oncology Group < 2 vs. >= 2; p = 0.0002), beta(2)-microglobulin level (< 5.5 vs. = 5.5 mg/L; p = 0.0481), and cumulative dose of bortezomib (< 35.1 vs. = 35.1 mg/m(2); p < 0001). The common adverse events (AEs) were in line with the well-known toxicity profiles associated with VMP. In conclusion, VMP is a feasible and effective front-line treatment for transplant-ineligible older patients with MM in Korea. Continuing therapy with prompt adjustment of treatment according to AEs may be important to improve outcomes of elderly patients.
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