Comparisons of efficacy between frontline treatment with bortezomib-melphalan-prednisone and lenalidomide-dexamethasone for transplant-ineligible multiple myeloma: a multicenter real-world based registry report, CAREMM-2102 study.
J Cancer Res Clin Oncol
; 149(13): 11907-11918, 2023 Oct.
Article
en En
| MEDLINE
| ID: mdl-37418057
ABSTRACT
BACKGROUND:
Bortezomib-melphalan-prednisone (VMP) and lenalidomide-dexamethasone (Rd) remain the standard treatments for transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). This study aimed to compare real-world benefits between the two regimens. We also were interested in exploring efficacy according to subsequent therapy following VMP or Rd.METHODS:
A total of 559 NDMM patients treated with VMP (n = 443, 79.2%) or Rd (n = 116, 20.8%) was recruited retrospectively from a multicenter database.RESULTS:
Rd provided more benefits than VMP-overall response rate 92.2 vs. 81.8%, p = 0.018; median progression-free survival (PFS) 20.0 vs. 14.5 months, p <0.001; second PFS (PFS2) 43.9 vs. 36.9 months, p = 0.012; overall survival (OS) 100.1 vs. 85.0 months, p = 0.017. Multivariable analysis revealed significant benefits of Rd over VMP, with hazard ratios of 0.722, 0.627, and 0.586 for PFS, PFS2, and OS, respectively. In propensity score-matched cohorts with matched VMP (n = 201) and Rd (n = 67) arms to balance baseline characteristics, Rd still showed significantly better outcomes for PFS, PFS2, and OS than VMP. Following VMP failure, triplet therapy showed significant benefits for response and PFS2; after Rd failure, PFS2 with carfilzomib-dexamethasone was significantly better than bortezomib-based doublet treatment.CONCLUSION:
These real-world findings may assist with better selection between VMP and Rd as well as subsequent therapy for NDMM.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Mieloma Múltiple
Tipo de estudio:
Clinical_trials
/
Observational_studies
/
Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Cancer Res Clin Oncol
Año:
2023
Tipo del documento:
Article