J Korean Med Sci.  2013 Jan;28(1):80-86. 10.3346/jkms.2013.28.1.80.

Early Response to Bortezomib Combined Chemotherapy Can Help Predict Survival in Patients with Multiple Myeloma Who Are Ineligible for Stem Cell Transplantation

• Lee HS
• Kim YS
• Kim K
• Kim JS
• Kim HJ
• Min CK
• Suh C
• Eom HS
• Yoon SS
• Lee JH
• Kim MK
• Kim SH
• Bae SH
• Mun YC
• Jo DY
• Chung JS
• The Korean Multiple Myeloma Working Party (KMMWP)

• KMID: 2158005
• DOI: http://doi.org/10.3346/jkms.2013.28.1.80

Abstract

Novel agents to treat multiple myeloma (MM) have increased complete respone (CR) rates compared with conventional chemotherapy, and the quality of the response to treatment has been correlated with survival. The purpose of our study was to show how of early response to bortezomib combined chemotherapy influences survival in patients with newly diagnosed MM who are ineligible for stem cell transplantation. We assessed patient responses to at least four cycles of bortezomib using the International Myeloma Working Group response criteria. The endpoints were comparisons of progression free survival (PFS) and overall survival (OS) between early good response group (A group) and poor response group (B group). We retrospectively analyzed data from 129 patients registered by the Korean Multiple Myeloma Working Party, a nationwide registration of MM patients. The 3 yr PFS for the A and B groups was 55.6% and 18.4%, respectively (P < 0.001). The 3 yr OS for the A and B groups was 65.3% and 52.9%, respectively (P = 0.078). The early response to at least four cycle of bortezomib before next chemotherapy may help predict PFS in patients with MM who are ineligible stem cell transplantation.

Keyword

Early Response; Multiple Myeloma; Bortezomib; Survival

MeSH Terms

Aged
Antineoplastic Agents/*therapeutic use
Boronic Acids/*therapeutic use
Disease-Free Survival
drugs Therapy, Combination
Female
Humans
Male
Middle Aged
Multiple Myeloma/*drug therapy/mortality
Predictive Value of Tests
Pyrazines/*therapeutic use
Registries
Retrospective Studies
*Stem Cell Transplantation
Treatment Outcome
Antineoplastic Agents
Boronic Acids
Pyrazines

Figure

• 

  Fig. 1 Comparison of progression free survival (PFS) and overall survival (OS) rates between the early good and poor response groups. The early good response group has a higher PFS (P < 0.001) (A). The early good response group tends to have a higher OS (P = 0.0078) (B). CR, complete response; VGPR, very good partial response; PR, partial response; SD, stable disease; PD, progressive disease.

• 

  Fig. 2 Comparison of progression free survival (PFS) and overall survival (OS) rates between the early and delayed response groups. The early response group has a higher PFS (P = 0.031) (A). There is shown no difference between the groups in terms of OS (P = 0.831) (B). CR, complete response; VGPR, very good partial response; PR, partial response; SD, stable disease; PD, progressive disease.

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