alexa Bortezomib plus dexamethasone versus reduced-dose bortezomib, thalidomide plus dexamethasone as induction treatment before autologous stem cell transplantation in newly diagnosed multiple myeloma.
Haematology

Haematology

Journal of Blood Disorders & Transfusion

Author(s): Moreau P, AvetLoiseau H, Facon T, Attal M, Tiab M,

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Abstract The Intergroupe Francophone du Myelome conducted a randomized trial to compare bortezomib-dexamethasone (VD) as induction before high-dose therapy (HDT) and autologous stem cell transplantation (ASCT) to a combination consisting of reduced doses of bortezomib and thalidomide plus dexamethasone (vtD) in patients with multiple myeloma. Overall, a total of 199 patients were centrally randomly assigned to receive VD or vtD. After 4 cycles, the complete response (CR) rate was the same in both groups (13\% in the vtD arm, 12\% in the VD arm, P = .74). However, the CR plus very good partial response (VGPR) rate was significantly higher in the vtD arm (49\% vs 36\%, P = .05). After ASCT, the CR plus VGPR rate was significantly higher in the vtD arm (74\% vs 58\%, P = .02). The reduced doses of bortezomib and thalidomide translated into a reduced incidence of peripheral neuropathy (PN): grade ≥ 2 PN were reported in 34\% in the VD arm versus 14\% in the vtD arm (P = .001). vtD, including reduced doses of bortezomib and thalidomide, yields higher VGPR rates compared with VD and can be considered a new effective triplet combination before HDT/ASCT. TRIAL REGISTRATION: ClinicalTrials.gov NCT00910897. This article was published in Blood and referenced in Journal of Blood Disorders & Transfusion

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