Bortezomib, lenalidomide, and dexamethasone in transplant-eligible newly diagnosed multiple myeloma patients: a multicenter retrospective comparative analysis
The combination of bortezomib, lenalidomide, and dexamethasone (VRD) is used as induction treatment in multiple myeloma; however, the optimum schedule for this regimen remains controversial. In this retrospective study, we compared the efficacy and tolerability of twice-weekly VRD (twVRD) and modified VRD-lite in transplant-eligible myeloma patients. Fifty-five patients (median age 61 years) were included; 22 received twVRD (bortezomib [1.3 mg/m2 on days 1, 4, 8, and 11] and lenalidomide [25 mg/body on days 1–14] over 21-day cycles) and 33 received modified VRD-lite (bortezomib [1.3 mg/m2 on days 1, 8, 15, and 22) and lenalidomide [15 mg/body on days 2–7, 9–14, 16–21] over 28-day cycles). Overall response, very good partial response, and complete response rates after VRD were 96.4%, 45.5%, and 20.0%, respectively (median follow-up period, 17.7 months). The 1-year progression-free survival (PFS) and overall survival rates were 95.8% and 98.2%, respectively. The response rate and PFS were similar between the groups, regardless of cytogenetic risk and age. The incidence of peripheral neuropathy ≥ grade 2 and thrombocytopenia ≥ grade 3 was higher in the twVRD group (27.2% vs. 0.0%, P = 0.003 and 27.2% vs. 0.0%, P = 0.003). In conclusion, modified VRD-lite had similar efficacy with, but better tolerability than, twVRD in transplant-eligible patients.
KeywordsMultiple myeloma Bortezomib Lenalidomide Induction treatment Peripheral neuropathy
We would like to thank the attending doctors and nurses at the Jikei University Kashiwa Hospital, the Japanese Red Cross Medical Center, the Cancer Institute Hospital, the Japanese Foundation for Cancer Research, and Hamamatsu University School of Medicine. We would also like to extend our gratitude to the myeloma patients and their families for consenting to participate in our study.
Compliance with ethical standards
Conflict of interest
K. Suzuki received personal fees from Takeda Pharmaceutical Company, Janssen Pharmaceutical K.K., Bristol-Myers Squibb, and Celgene, outside the submitted work; N. Tsukada received a personal fee from Takeda, outside the submitted work; N. Nishimura received personal fees from Takeda Pharmaceutical Company, Janssen Pharmaceutical K.K., and Chugai Pharmaceutical. Co., Ltd., outside the submitted work; Y. Mishima reports personal fees from Chugai Pharmaceutical. Co., Ltd., Roche group, outside the submitted work; M. Yokoyama received personal fees from Chugai Pharmaceutical. Co., Ltd., outside the submitted work; K. Nishiwaki reports grants from Novartis Pharma K.K., and grants and personal fees from Kyowa Hakko Kirin Co, Ltd, outside the submitted work; T. Ishida received personal fees from Janssen, Celgene, Ono Pharmaceuticals, Bristol-Myers Squibb, and Takeda, outside the submitted work. The other authors declare that they have no conflicts of interest.
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