Weekly bortezomib, pegylated liposomal doxorubicin, and dexamethasone is a safe and effective therapy for elderly patients with relapsed/refractory multiple myeloma.
BACKGROUND
The synergic, additive effect of bortezomib and pegylated liposomal doxorubicin (PLD) has never been tested in an elderly group of patients with relapsed/refractory multiple myeloma (MM).


METHODS
In this study, 25 patients with a median age of 75 years were treated with bortezomib at usual doses of 1.3 mg/m2 every 21 days. After 2 cycles, bortezomib was given intravenously (I.V.) weekly every 32 days. Pegylated liposomal doxorubicin 30 mg/m2 I.V. was given on day 4 for 2 cycles and then was given on day 8;. Dexamethasone 40 mg I.V. was given on days 1-4 for 2 cycles and then 20 mg weekly.


RESULTS
Bortezomib/PLD/dexamethasone therapy resulted in 20 of 25 objective responses for an overall response rate of 80% (complete remission + very good partial remission, 66%). Median overall survival was not reached. Median duration of response (progression-free survival) was 8 months. Eleven of 16 patients (68%) with > or = VGPR still maintain a response at a median of 12 months versus 4 months for patients with < VGPR (PFS, overall survival; P = .0001). Grade 3/4 toxicities were mild in most of the patients.


CONCLUSIONS
Bortezomib/ PLD/dexamethasone combination is safe and effective in elderly patients with resistant-relapsing MM.
Gozzetti
Alessandro
A
Division of Hematology and Transplants, University of Siena, Italy. gozzetti@unisi.it
Fabbri
Alberto
A
Oliva
Stefania
S
Marchini
Elena
E
Bocchia
Monica
M
Defina
Marzia
M
Lauria
Francesco
F
D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage; D000069286:Bortezomib; D003907:Dexamethasone / Q000008:administration & dosage; D004317:Doxorubicin / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008297:Male; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000401:mortality; D011092:Polyethylene Glycols; D011719:Pyrazines / Q000008:administration & dosage
D001897:Boronic Acids; D011719:Pyrazines; C506643:liposomal doxorubicin; D011092:Polyethylene Glycols; D000069286:Bortezomib; D003907:Dexamethasone; D004317:Doxorubicin