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. 2013 Mar;139(3):499-508.
doi: 10.1007/s00432-012-1339-3. Epub 2012 Nov 25.

Combined bendamustine, prednisone and bortezomib (BPV) in patients with relapsed or refractory multiple myeloma

Wolfram Pönisch  1 , Malvina Bourgeois, Barbara Moll, Simone Heyn, Nadja Jäkel, Ina Wagner, Robert Rohrberg, Hans-Jürgen Hurtz, Marion Schmalfeld, Michael Aßmann, Thomas Edelmann, Martin Mohren, Franz Albert Hoffmann, Cornelia Becker, Andreas Schwarzer, Uta Schönfelder, Thomas Zehrfeld, Gerald Hensel, Kerstin Löschcke, Rainer Krahl, Haifa Al Ali, Dietger Niederwieser
Affiliations

Combined bendamustine, prednisone and bortezomib (BPV) in patients with relapsed or refractory multiple myeloma

Wolfram Pönisch et al. J Cancer Res Clin Oncol. 2013 Mar.

Abstract

Introduction: Bortezomib (Velcade) is a proteasome inhibitor that has shown important clinical efficacy either as a single agent or in combination with other cytostatic agents in multiple myeloma (MM). In the present protocol, bortezomib was combined with other active substances like bendamustine and prednisone (BPV), in order to assess the efficacy and toxicity of the combination therapy in patients with relapsed or refractory MM.

Methods: Between January 2005 and December 2011, 78 patients with relapsed or refractory MM were treated with bendamustine 60 (-120) mg/m(2) on days 1 and 2, bortezomib 1.3 mg/m(2) on days 1, 4, 8 and 11, and prednisone 100 mg on days 1, 2, 4, 8 and 11. The median number of prior therapies was 2 with a wide range of 1-9. Thirty-three patients had pre-existing severe thrombocytopenia and/or neutropenia (WHO grade 3 or 4).

Results: A median number of two (range 1-7) BPV treatment cycles were given to the patients. The majority of the patients (n = 54; 69 %) responded after at least one cycle of chemotherapy with 3 CR, 10 nCR, 10 VGPR and 31 PR. Median PFS and OS for patients without severe hematological toxicities due to previous treatments (n = 45) were 11 and 50 months, respectively. Outcome for these patients was significantly better than that for patients with severe hematological toxicities (grade 3 or 4, n = 33) with a PFS, and OS of 3 months (p < 0.05) and 5 months (p < 0.001), respectively. The regimen was well tolerated with few significant side effects in patients without severe hematological toxicities due to previous treatments. These results indicate that the combination of bortezomib, bendamustine and prednisone is well tolerated in patients with relapsed or refractory MM.

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Figures

Fig. 1
Fig. 1
Cumulative percentage of hematological response after each BPV cycle: a comprises 45 patients with normal bone marrow function; b comprises 33 patients with restricted bone marrow function
Fig. 2
Fig. 2
Progression-free survival in 78 patients with advanced multiple myeloma treated with BPV: group A comprises 45 patients with normal bone marrow function; group B comprises 33 patients with restricted bone marrow function
Fig. 3
Fig. 3
Overall survival in 78 patients with advanced multiple myeloma treated with BPV: group A comprises 45 patients with normal bone marrow function; group B comprises 33 patients with restricted bone marrow function
See this image and copyright information in PMC

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