title: The choice of regimens based on bortezomib for patients with newly diagnosed multiple myeloma.
abstract: BACKGROUND
  Bortezomib has significantly improved multiple myeloma (MM) response rates, but strategies for choosing bortezomib-based regimens for initial MM therapy are not standardized. Here, we describe four bortezomib-based therapies in Chinese MM patients to determine the optimal chemotherapeutic approach.
  
  
  METHODS
  Newly diagnosed symptomatic MM patients at three hematological centers between February 1, 2006 and May 31, 2013 were treated with therapies including bortezomib plus dexamethasone (PD) or combinations of PD with either adriamycin (PAD), cyclophosphamide (PCD) or thalidomide (PTD) for every 28 days.
  
  
  RESULTS
  The overall response rate of all the 215 eligible patients was 90.2%. The ORR for PCD, PAD, PTD and PD were 97.4%, 93.2%, 85.3% and 77.8% while the effects with VGPR or better were 63.7%, 62.7%, 44.2% and 37.8%, respectively. The effect of ORR, VGPR and CR/nCR for the PCD regimen was better than the PD protocol. Median PFS for all patients was 29.0 months with significant differences observed among treatment groups. Median OS of all the patients was not reached, but three-drug combinations were superior to PD alone. Frequently observed toxicities were neutropenia, thrombocytopenia, fatigue, infection, herpes zoster, and peripheral neuropathy. The incidence of peripheral neuropathy (PN) in PTD group was significantly higher than other three groups, especially grade 2-3 PN. Treatment with anti-viral agent acyclovir significantly reduced the incidence of herpes zoster.
  
  
  CONCLUSIONS
  Our experience indicated that bortezomib-based regimens were effective and well-tolerated in the Chinese population studied; three-drug combinations PCD, PAD were superior to PD, especially with respect to PCD.
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Jingsong
authors.initials: J
authors.lastname: He
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Yang
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Han
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Gaofeng
authors.initials: G
authors.lastname: Zheng
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Weiyan
authors.initials: W
authors.lastname: Zheng
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Guoqing
authors.initials: G
authors.lastname: Wei
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Wu
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Xiujin
authors.initials: X
authors.lastname: Ye
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Jimin
authors.initials: J
authors.lastname: Shi
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Wanzhuo
authors.initials: W
authors.lastname: Xie
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Li
authors.initials: L
authors.lastname: Li
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Jie
authors.initials: J
authors.lastname: Zhang
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Weijia
authors.initials: W
authors.lastname: Huang
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: He
authors.initials: H
authors.lastname: Huang
authors.affiliation: Department of Hematology, Red Cross Hospital in Hangzhou, Zhejiang, P. R. China.
authors.forename: Xuejin
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Hematology, Shaoxing People's Hospital, Zhejiang, P. R. China.
authors.forename: Jiaping
authors.initials: J
authors.lastname: Fu
authors.affiliation: The Bone Marrow Transplantation center & Multiple Myeloma Treatment Center, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, Zhejiang, P. R. China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Cai
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D001897:Boronic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D011719:Pyrazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib