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Changes in Osteoblastic Activity in Patient Who Received Bortezomib as Second Line Treatment for Plasma Cell Myeloma: A Prospective Multicenter Study

 Ki-Seong Eom  ;  Seok Jin Kim  ;  Je-Jung Lee  ;  Cheolwon Suh  ;  Jin Seok Kim  ;  Sung-Soo Yoon  ;  Byung Soo Kim  ;  Hye Jin Kang  ;  Young Jin Choi  ;  Chul Soo Kim  ;  Yang Soo Kim  ;  Jae-Yong Kwak  ;  Yoo Jin Kim  ;  Young Don Joo  ;  Yeung-Chul Mun  ;  Deog Yeon Jo  ;  Joon Seong Park  ;  Chi-Young Park  ;  Sung-Hyun Kim  ;  Chang-Ki Min 
 BIOMED RESEARCH INTERNATIONAL, Vol.2014 : 245247, 2014 
Journal Title
Issue Date
Adult ; Biomarkers/metabolism ; Bone and Bones/drug effects ; Bone and Bones/pathology ; Boronic Acids/pharmacology ; Boronic Acids/therapeutic use* ; Bortezomib ; Female ; Humans ; Male ; Middle Aged ; Multiple Myeloma/complications ; Multiple Myeloma/drug therapy* ; Osteoblasts/drug effects ; Osteoblasts/pathology ; Peripheral Nervous System Diseases/complications ; Peripheral Nervous System Diseases/drug therapy ; Prospective Studies ; Pyrazines/pharmacology ; Pyrazines/therapeutic use* ; Steroids/pharmacology ; Steroids/therapeutic use ; Treatment Outcome
We conducted a prospective multicenter study identifying the role of bortezomib in patients with relapsed or refractory plasma cell myeloma (PCM) in bone resorption and formation via bone turnover markers. A total of 104 patients received at least 1 cycle of bortezomib. Most of them had advanced disease (n = 89). Among them, 75 patients completed 4 cycles of treatment. Most of the patients (81.7%) were treated in combination with steroid. After the 4th cycle treatment, 47 of 75 patients achieved CR, nCR, VGPR, and PR (64.4%), while 26 patients achieved less than PR (35.6%). The proportion of patients who achieved ≥ PR increased as patients received more treatment cycles, reaching 90% after the 8th cycle. DKK-1 levels decreased significantly posttreatment. Bone formation markers (bALP and OC) and osteoclast regulator such as sRANKL also decreased significantly. These findings were observed primarily in patients who received steroid and who had a longer disease duration. While sRANKL demonstrated significant reduction posttreatment, osteoprotegerin (OPG) level did not significantly change posttreatment, resulting in a decreased sRANKL/OPG ratio (P = 0.037). In conclusion, our clinical data suggest that treatment with bortezomib and steroid may rearrange the metabolic balance between osteoblast and osteoclast activities in PCM.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
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