[Bortezomib-based combination therapy for relapsed or refractory multiple myeloma]

Area of Science:

• Hematology
• Oncology
• Clinical Pharmacology

Background:

• Multiple myeloma (MM) is a hematologic malignancy characterized by uncontrolled proliferation of plasma cells.
• Relapsed or refractory MM presents significant treatment challenges, necessitating novel therapeutic strategies.
• Bortezomib has emerged as a key agent in MM treatment, but its optimal combination regimens require further investigation.

Purpose of the Study:

• To evaluate the efficacy and toxicity of bortezomib-based combination therapies in Chinese patients with relapsed or refractory multiple myeloma (MM).
• To determine optimal combination regimens, dosages, and treatment cycles for bortezomib in MM therapy.
• To compare the outcomes of bortezomib-based regimens with historical control data from thalidomide-based therapies.

Main Methods:

• A cohort of 46 patients with relapsed/refractory MM received bortezomib (1.3 mg/m2) twice weekly for 2 weeks per 3-4 week cycle, combined with various regimens (dexamethasone, dexamethasone plus thalidomide, CD, MD, DCEP, DT-PACE).
• Treatment response was assessed using International Myeloma Working Group (IMWG) criteria.
• Adverse events were graded per National Cancer Institute Common Toxicity Criteria v3.0; a historical control group (n=49) received thalidomide-based therapy.

Main Results:

• An overall response rate (ORR) of 72.1% was observed in evaluable patients (n=43), significantly higher than the control group's 51.0% (P < 0.05).
• Complete response (CR) was achieved in 11.6%, very good partial response (VGPR) in 27.9%, and partial response (PR) in 32.6%.
• Frequent adverse events included thrombocytopenia (62.8%), fatigue (55.8%), nausea (51.2%), and peripheral neuropathy (30.2%), all deemed tolerable.

Conclusions:

• Bortezomib-based combination therapy represents a highly effective treatment for relapsed or refractory MM patients.
• This approach demonstrates a superior response rate compared to traditional thalidomide-based combinations.
• The observed toxicities are manageable, positioning bortezomib combinations as a valuable therapeutic option for MM.