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. 2024 Nov 12;16(22):3805.
doi: 10.3390/cancers16223805.

A Short Course of Standard Velcade/Dexamethasone Followed by Unlimited Weekly Maintenance Therapy Is an Effective Treatment in Relapsed/Refractory Multiple Myeloma

Harini Acharya Gangur  1 , Harsha Trivedi  2 , UshaSree Chamarthy  3 , Anas Al-Janadi  4 , Gordan Srkalovic  2
Affiliations

A Short Course of Standard Velcade/Dexamethasone Followed by Unlimited Weekly Maintenance Therapy Is an Effective Treatment in Relapsed/Refractory Multiple Myeloma

Harini Acharya Gangur et al. Cancers (Basel). .

Abstract

Background: Bortezomib (B), known as Velcade, is a reversible proteasome inhibitor approved for relapsed/refractory multiple myeloma (RRMM) patients (pts). The standard of care protocol includes eight cycles of intravenous push (IVP) injections of B and oral dexamethasone (D), which increases the toxicity. Here, we describe the results of an open-label, phase II clinical trial employing only four cycles of B/D.

Methods: RRMM pts treated with at least one previous therapy qualified for the trial. Pts were treated with B 1.3 mg/m2 IVP or subcutaneous (SC) on day 1, 4, 8, and 11, followed by a 10-day rest, Q21 days for four cycles; followed by maintenance therapy with once weekly B 1.6 mg/m2 IVP or SC on day 1, 8, 15, and 22, followed by 13 days' rest, repeated Q36 day. Pts received D 20 mg on the days of and days after B. Pts with a complete response (CR) were removed. Those with a partial response (PR) or stable disease (SD) were placed on maintenance therapy until progressive disease (PD), unacceptable toxicity, or pts' decision to stop.

Results: A total of 24 pts were enrolled. CR was observed in six pts (25%), PR in eight pts (33%), and SD in nine pts (37.5%). Moreover, 14 of the 24 pts (58.3%) had PR or better. Four pts had PD during induction. The grade 3 toxicities included fatigue (58%), sensory neuropathy (54%), and thrombocytopenia (50%); the grade 4 toxicities were thrombocytopenia (12.5%), fatigue (12.5%), and sensory neuropathy (12.5%).

Conclusions: A short course of B/D, plus maintenance with B, is well tolerated in RRMM pts. Long-term maintenance with B/D could become an alternative to new agents.

Keywords: Velcade; bortezomib; clinical trials; multiple myeloma; relapsed/refractory; shortened therapy.

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Conflict of interest statement

Dr. Al-Janadi received research funding from Merck. There are no other conflicts of interest to disclose. All the other authors declare that they have no conflicts of interest, financial or otherwise, to disclose.

Figures

Figure 1
Figure 1
Overall survival (OS) with number at risk.
Figure 2
Figure 2
Progression-free survival (PFS) with number at risk.
See this image and copyright information in PMC

References

    1. Rajkumar S.V. Multiple Myeloma: Every Year a New Standard? Hematol. Oncol. 2019;37:62–65. doi: 10.1002/hon.2586. - DOI - PMC - PubMed
    1. Kumar S.K., Rajkumar S.V., Dispenzieri A., Lacy M.Q., Hayman S.R., Buadi F.K., Zeldenrust S.R., Dingli D., Russell S.J., Lust J.A., et al. Improved Survival in Multiple Myeloma and the Impact of Novel Therapies. Blood. 2008;111:2516–2520. doi: 10.1182/blood-2007-10-116129. - DOI - PMC - PubMed
    1. Kumar S.K., Dispenzieri A., Lacy M.Q., Gertz M.A., Buadi F.K., Pandey S., Kapoor P., Dingli D., Hayman S.R., Leung N., et al. Continued Improvement in Survival in Multiple Myeloma: Changes in Early Mortality and Outcomes in Older Patients. Leukemia. 2014;28:1122–1128. doi: 10.1038/leu.2013.313. - DOI - PMC - PubMed
    1. Laubach J., Garderet L., Mahindra A., Gahrton G., Caers J., Sezer O., Voorhees P., Leleu X., Johnsen H.E., Streetly M., et al. Management of Relapsed Multiple Myeloma: Recommendations of the International Myeloma Working Group. Leukemia. 2016;30:1005–1017. doi: 10.1038/leu.2015.356. - DOI - PubMed
    1. Nooka A.K., Kastritis E., Dimopoulos M.A., Lonial S. Treatment Options for Relapsed and Refractory Multiple Myeloma. Blood. 2015;125:3085–3099. doi: 10.1182/blood-2014-11-568923. - DOI - PubMed

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