Bortezomib use and outcomes for the treatment of multiple myeloma.
Intern Med J
; 50(9): 1059-1066, 2020 09.
Article
in En
| MEDLINE
| ID: mdl-32369254
ABSTRACT
BACKGROUND:
The public subsidy in Australia of bortezomib (Velcade) for untreated non-transplant multiple myeloma patients was based on the VISTA trial.AIMS:
To ascertain the health outcomes of bortezomib in 'real world' transplant-ineligible elderly patients, compared to trial data.METHODS:
Patient and treatment data were extracted from an oncology information system, laboratory information system and medical chart audits for three Queensland public hospitals.RESULTS:
We identified 74 patients; the median age was 75 years. Our cohort comprised 47% patients who were International Staging System stage III, 45% at stage II and 8% at stage I. Patients who had comorbidities, such as cardiac disease (41%), pulmonary disease (14%), diabetes (22%), peripheral neuropathy (14%) and other comorbidities (41%) at baseline were included. The common regimens prescribed were VMP, CVD and VD, and most patients (n = 73) received bortezomib on a once-weekly or twice-a-week basis. The overall response rate was 81%. Half (53%) of the patients did not complete their planned therapy due to toxicity (30%), suboptimal response or disease progression (15%), or death on treatment (8%). Overall survival was 40.7 months and progression free survival was 17.7 months.CONCLUSIONS:
Our patients were older, had worse disease characteristics and more comorbidities than patients in the VISTA trial. While response rates were similar, survival outcomes appeared worse. Bortezomib-based treatment in the real world setting still carries a high risk of toxicity in the elderly population.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Multiple Myeloma
Type of study:
Prognostic_studies
Limits:
Aged
/
Humans
Country/Region as subject:
Oceania
Language:
En
Journal:
Intern Med J
Journal subject:
MEDICINA INTERNA
Year:
2020
Document type:
Article
Affiliation country:
Australia