title: Bortezomib and dexamethasone as salvage therapy in patients with relapsed/refractory multiple myeloma: analysis of long-term clinical outcomes.
abstract: Bortezomib (bort)-dexamethasone (dex) is an effective therapy for relapsed/refractory (R/R) multiple myeloma (MM). This retrospective study investigated the combination of bort (1.3 mg/m(2) on days 1, 4, 8, and 11 every 3 weeks) and dex (20 mg on the day of and the day after bort) as salvage treatment in 85 patients with R/R MM after prior autologous stem cell transplantation or conventional chemotherapy. The median number of prior lines of therapy was 2. Eighty-seven percent of the patients had received immunomodulatory drugs included in some line of therapy before bort-dex. The median number of bort-dex cycles was 6, up to a maximum of 12 cycles. On an intention-to-treat basis, 55 % of the patients achieved at least partial response, including 19 % CR and 35 % achieved at least very good partial response. Median durations of response, time to next therapy and treatment-free interval were 8, 11.2, and 5.1 months, respectively. The most relevant adverse event was peripheral neuropathy, which occurred in 78 % of the patients (grade II, 38 %; grade III, 21 %) and led to treatment discontinuation in 6 %. With a median follow up of 22 months, median time to progression, progression-free survival (PFS) and overall survival (OS) were 8.9, 8.7, and 22 months, respectively. Prolonged PFS and OS were observed in patients achieving CR and receiving bort-dex a single line of prior therapy. Bort-dex was an effective salvage treatment for MM patients, particularly for those in first relapse.
authors.affiliation: "Seràgnoli" Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Pantani
authors.forename: Elena
authors.initials: E
authors.lastname: Zamagni
authors.forename: Beatrice Anna
authors.initials: BA
authors.lastname: Zannetti
authors.forename: Annalisa
authors.initials: A
authors.lastname: Pezzi
authors.forename: Paola
authors.initials: P
authors.lastname: Tacchetti
authors.forename: Annamaria
authors.initials: A
authors.lastname: Brioli
authors.forename: Katia
authors.initials: K
authors.lastname: Mancuso
authors.forename: Giulia
authors.initials: G
authors.lastname: Perrone
authors.forename: Serena
authors.initials: S
authors.lastname: Rocchi
authors.forename: Patrizia
authors.initials: P
authors.lastname: Tosi
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects; D000069286:Bortezomib; D003131:Combined Modality Therapy; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects; D004341:Drug Evaluation; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000139:chemically induced; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000601:surgery; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D061988:Proteasome Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D016879:Salvage Therapy; D013921:Thrombocytopenia / Q000139:chemically induced; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D007155:Immunologic Factors; D061988:Proteasome Inhibitors; D011719:Pyrazines; D000069286:Bortezomib; D003907:Dexamethasone