TY - JOUR
T1 - Bortezomib, melphalan, prednisone (VMP) versus melphalan, prednisone, thalidomide (MPT) in elderly newly diagnosed multiple myeloma patients
T2 - A retrospective case-matched study
AU - Morabito, Fortunato
AU - Bringhen, Sara
AU - Larocca, Alessandra
AU - Wijermans, Pierre
AU - Victoria Mateos, Maria
AU - Gimsing, Peter
AU - Mazzone, Carla
AU - Gottardi, Daniela
AU - Omedè, Paola
AU - Zweegman, Sonja
AU - José Lahuerta, Juan
AU - Zambello, Renato
AU - Musto, Pellegrino
AU - Magarotto, Valeria
AU - Schaafsma, Martijn
AU - Oriol, Albert
AU - Juliusson, Gunnar
AU - Cerrato, Chiara
AU - Catalano, Lucio
AU - Gentile, Massimo
AU - Isabel Turel, Ana
AU - Marina Liberati, Anna
AU - Cavalli, Maide
AU - Rossi, Davide
AU - Passera, Roberto
AU - Rosso, Stefano
AU - Beksac, Meral
AU - Cavo, Michele
AU - Waage, Anders
AU - San Miguel, Jesus
AU - Boccadoro, Mario
AU - Sonneveld, Pieter
AU - Palumbo, Antonio
AU - Offidani, Massimo
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/84897388164
U2 - 10.1002/ajh.23641
DO - 10.1002/ajh.23641
M3 - Article
SN - 0361-8609
VL - 89
SP - 355
EP - 362
JO - American Journal of Hematology
JF - American Journal of Hematology
IS - 4
ER -