Modified HyperCVAD Versus Bortezomib-HyperCAD in Patients With Relapsed/Refractory Multiple Myeloma

Area of Science:

• Hematology
• Oncology
• Clinical Pharmacy

Background:

• Multiple myeloma (MM) is an incurable plasma cell malignancy.
• Aggressive relapses of MM may necessitate salvage cytotoxic infusional chemotherapy.
• Bortezomib has replaced vincristine in the modified hyperCVAD regimen, creating the bortezomib-hyperCAD regimen.

Purpose of the Study:

• To retrospectively evaluate the effectiveness and tolerability of modified hyperCVAD versus bortezomib-hyperCAD in patients with relapsed and/or refractory MM.
• To compare overall response rates, progression-free survival (PFS), and overall survival (OS) between the two regimens.
• To assess the incidence of adverse events, including febrile neutropenia and peripheral neuropathy.

Main Methods:

• Retrospective analysis of 33 patients with relapsed/refractory MM treated between 2011 and 2015.
• Patients received either modified hyperCVAD or bortezomib-hyperCAD for at least one cycle.
• Effectiveness and tolerability outcomes were compared between the two treatment arms.

Main Results:

• Overall response rates were comparable: 40% for modified hyperCVAD and 44.4% for bortezomib-hyperCAD.
• Median PFS was 6.3 months for modified hyperCVAD and 6.6 months for bortezomib-hyperCAD.
• Median OS was 11.1 months for modified hyperCVAD and 13.8 months for bortezomib-hyperCAD, with no significant difference between groups.

Conclusions:

• Modified hyperCVAD and bortezomib-hyperCAD demonstrate similar effectiveness and tolerability in treating relapsed MM.
• Both regimens achieve impressive response rates in heavily pretreated and refractory MM patients.
• No significant differences in adverse events like febrile neutropenia or peripheral neuropathy were observed.