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A prospective, open-label, multicenter, observational study to evaluate the efficacy and safety of bortezomib-melphalan-prednisone as initial treatment for autologous stem cell transplantation-ineligible patients with multiple myeloma

Authors
 Min Kyoung Kim  ;  Kihyun Kim  ;  Chang-Ki Min  ;  Jae-Yong Kwak  ;  Sang-Byung Bae  ;  Sung-Soo Yoon  ;  Je-Jung Lee  ;  Ki Hwan Kim  ;  Seung-Hyun Nam  ;  Yeung-Chul Mun  ;  Hyo Jung Kim  ;  Sung Hwa Bae  ;  Ho-Jin Shin  ;  Jung-Hee Lee  ;  Joon Seong Park  ;  Seong Hyun Jeong  ;  Mark Hong Lee  ;  Yang-Soo Kim  ;  Ho Sup Lee  ;  Keon Woo Park  ;  Won-Sik Lee  ;  Sang Min Lee  ;  Jeong-Ok Lee  ;  Myung Soo Hyun  ;  Deog Yeon Jo  ;  Sung-Nam Lim  ;  Jae Hoon Lee  ;  Do-Yeun Cho  ;  Young Rok Do  ;  Jeong-A Kim  ;  Seong Kyu Park  ;  Jin Seok Kim  ;  Soo-Jeong Kim  ;  Hawk Kim  ;  Hyeon Gyu Yi  ;  Joon Ho Moon  ;  Chul Won Choi  ;  Sung-Hyun Kim  ;  Young-Don Joo  ;  Hoon-Gu Kim  ;  Byung Soo Kim  ;  Moo-Rim Park  ;  Moo-Kon Song and Su-Youn Kim 
Citation
 ONCOTARGET , Vol.8(23) : 37605-37618, 2017 
Journal Title
 ONCOTARGET 
Issue Date
2017
MeSH
Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/adverse effects ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Asian Continental Ancestry Group ; Bortezomib/administration & dosage ; Bortezomib/adverse effects ; Diarrhea/chemically induced ; Drug Administration Schedule ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Melphalan/administration & dosage ; Melphalan/adverse effects ; Middle Aged ; Multiple Myeloma/drug therapy* ; Multiple Myeloma/ethnology ; Multiple Myeloma/pathology ; Neoplasm Staging ; Neutropenia/chemically induced ; Prednisone/administration & dosage ; Prednisone/adverse effects ; Prospective Studies ; Republic of Korea ; Treatment Outcome
Keywords
aged ; bortezomib ; combination ; drug therapy ; multiple myeloma
Abstract
Bortezomib-melphalan-prednisone (VMP) showed superior efficacy versus MP as first-line treatment for transplantation-ineligible multiple myeloma (MM). This study investigated the efficacy of VMP for Korean patients with MM.Overall, 177 MM patients received 9 cycles of VMP in this prospective, multicenter, observational study. The primary endpoint was 2-year progression-free survival (PFS).Thirty-nine (22%) patients were aged ≥ 75 years and 83 (47.4%) patients had International Staging System stage III. A median of 5 cycles were delivered. Overall response rate (ORR) was 72.9%, and complete response (CR) rate was 20.3%. With a median follow-up of 11.9 months, median PFS was 17 months. The 2-year PFS and overall survival (OS) rates were 29.2% and 80.0%, respectively. Median OS was not reached. PFS was significantly different depending on performance status (Eastern Cooperative Oncology Group < 2 vs. ≥ 2; p = 0.0002), β2-microglobulin level (< 5.5 vs. ≥ 5.5 mg/L; p = 0.0481), and cumulative dose of bortezomib (< 35.1 vs. ≥ 35.1 mg/m2; p < 0001). The common adverse events (AEs) were in line with the well-known toxicity profiles associated with VMP.In conclusion, VMP is a feasible and effective front-line treatment for transplant-ineligible older patients with MM in Korea. Continuing therapy with prompt adjustment of treatment according to AEs may be important to improve outcomes of elderly patients.
Files in This Item:
T999901268.pdf Download
DOI
10.18632/oncotarget.16790
Appears in Collections:
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165810
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