title: Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients: A retrospective case-matched study.
abstract: Novel agents in combination with melphalan and prednisone (MP) significantly improved progression-free survival (PFS) and overall survival (OS) in multiple myeloma (MM). Randomized trials comparing MP plus bortezomib (VMP) versus MP plus thalidomide (MPT) are lacking. Nine hundred and fifty-six elderly (>65 years) newly diagnosed MM patients from six European randomized trials were retrospectively analyzed and matched for age, albumin, and beta2-microglobulin at diagnosis, 296 patients were selected from the VMP groups, and 294 from MPT. Complete response rate was 21% in the VMP patients and 13% in the MPT patients (P = 0.007). After a median follow-up of 34 months (range, 1-92), VMP significantly prolonged both PFS (median 32.5 vs. 22.9 months, HR 0.65; 95% CI 0.52-0.82; P < 0.001) and OS (median 79.7 vs. 45.1 months, HR 0.44; 95% CI 0.32-0.59; P < 0.001) in comparison with MPT. The benefit in terms of OS of the VMP group was quite similar among patients with different risk factors defined by sex, ISS, ECOG performance status, or serum creatinine but not among patients ≥ 75 years. Multivariate analysis confirmed that VMP was an independent predictor of longer PFS and OS. In a control-case matched analysis, PFS and OS were prolonged in patients who received VMP in comparison with those treated with MPT.
authors.affiliation: UOC Ematologia, A.O. di Cosenza, Torino, Italy.
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
authors.forename: Sara
authors.initials: S
authors.lastname: Bringhen
authors.forename: Alessandra
authors.initials: A
authors.lastname: Larocca
authors.forename: Pierre
authors.initials: P
authors.lastname: Wijermans
authors.forename: Maria
authors.initials: M
authors.lastname: Victoria Mateos
authors.forename: Peter
authors.initials: P
authors.lastname: Gimsing
authors.forename: Carla
authors.initials: C
authors.lastname: Mazzone
authors.forename: Daniela
authors.initials: D
authors.lastname: Gottardi
authors.forename: Paola
authors.initials: P
authors.lastname: Omedè
authors.forename: Sonja
authors.initials: S
authors.lastname: Zweegman
authors.forename: Juan
authors.initials: J
authors.lastname: José Lahuerta
authors.forename: Renato
authors.initials: R
authors.lastname: Zambello
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Valeria
authors.initials: V
authors.lastname: Magarotto
authors.forename: Martijn
authors.initials: M
authors.lastname: Schaafsma
authors.forename: Albert
authors.initials: A
authors.lastname: Oriol
authors.forename: Gunnar
authors.initials: G
authors.lastname: Juliusson
authors.forename: Chiara
authors.initials: C
authors.lastname: Cerrato
authors.forename: Lucio
authors.initials: L
authors.lastname: Catalano
authors.forename: Massimo
authors.initials: M
authors.lastname: Gentile
authors.forename: Ana
authors.initials: A
authors.lastname: Isabel Turel
authors.forename: Anna
authors.initials: A
authors.lastname: Marina Liberati
authors.forename: Maide
authors.initials: M
authors.lastname: Cavalli
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Stefano
authors.initials: S
authors.lastname: Rosso
authors.forename: Meral
authors.initials: M
authors.lastname: Beksac
authors.forename: Michele
authors.initials: M
authors.lastname: Cavo
authors.forename: Anders
authors.initials: A
authors.lastname: Waage
authors.forename: Jesus
authors.initials: J
authors.lastname: San Miguel
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
authors.forename: Massimo
authors.initials: M
authors.lastname: Offidani
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects; D000069286:Bortezomib; D016022:Case-Control Studies; D018572:Disease-Free Survival; D004341:Drug Evaluation; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000009:adverse effects; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000628:therapy; D009422:Nervous System Diseases / Q000139:chemically induced; D011241:Prednisone / Q000008:administration & dosage / Q000009:adverse effects; D011379:Prognosis; D016016:Proportional Hazards Models; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D013792:Thalidomide; D000069286:Bortezomib; D008558:Melphalan; D011241:Prednisone