Article

Efficacy and safety of reduced-intensity induction therapy with a bortezomib-based regimen in elderly patients with multiple myeloma.

S de Hematología, Hospital Universitario 12 de Octubre. Instituto de Investigación 12 de Octubre, Univ Complutense de Madrid, Madrid, Spain.
Therapeutic advances in hematology 06/2012; 3(3):147-54. DOI: 10.1177/2040620712440589
Source: PubMed

ABSTRACT The therapeutic effects of bortezomib in untreated and refractory/relapsed multiple myeloma have been demonstrated in several clinical trials, displaying superiority to the conventional treatments. However, many treatment-related toxicities, such as bone marrow suppression, infections and peripheral neuropathy, are well known and lead to treatment discontinuation and dose modification, especially in elderly patients. The purpose of this review is to summarize the published literature concerning the efficacy and safety of reduced-intensity induction therapy with bortezomib-based regimens in elderly patients with multiple myeloma. We used the VISTA trial as a reference and compared it with the seven trials identified in a systematic search. The data suggest that low-dose bortezomib significantly reduces therapy-related toxicities, especially neuropathy, and decreases the rate of discontinuation compared with the twice-weekly regimen, without losing efficacy. In light of this review, we suggest that once-weekly infusion of bortezomib in addition to melphalan-prednisone may be considered as a new standard of care in frontline treatment of elderly patients with symptomatic multiple myeloma.

0 Bookmarks
 · 
83 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Bortezomib is the first proteasome inhibitor drug tested in human patients. Bortezomib demonstrates a particular clinical utility in the treatment of multiple myeloma (MM), where it is the only one of the new drugs administered as mono-therapy that prolongs survival. The significant problem for the consistent pursuit of bortezomib was neurotoxicity, which has been significantly reduced by registering subcutaneous administration or being administered once per week. Bortezomib is currently approved for the treatment of patients with progressive MM in mono-therapy and in combination with prednisone and melphalan in cases of untreated patients who are not candidates for autologous hematopoietic stem cell transplantation (AHSCT) and in combination with dexamethasone or dexamethasone and thalidomide in untreated MM patients, who are candidates for treatment AHSCT. Clinical research is focused on the combination of bortezomib with other new drugs with the hope of further optimizing the treatment of patients with multiple myeloma.
    Expert Review of Hematology 04/2014; 7(2):173-85. DOI:10.1586/17474086.2014.899144 · 2.38 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Multiple myeloma is an incurable hematological disease previously associated with poor prognosis and survival rates. However, following the advent of the so-called novel agents, the goal of therapy has now moved to long-term disease control and potential cure. However, despite these advances, myeloma displays considerable heterogeneity and, over time, control of disease can be lost. In order to counteract this, new strategies are incorporating risk stratification to provide more individualized therapy. Furthermore, there is now increasing focus on adapting therapy in elderly and frail patients to improve compliance and maximize treatment benefit.
    11/2014; 4:121-134. DOI:10.2147/BLCTT.S46576

Full-text (2 Sources)

Download
49 Downloads
Available from
May 17, 2014