A Phase II trial of weekly bortezomib and dexamethasone in veterans with newly diagnosed multiple myeloma not eligible for or who deferred autologous stem cell transplantation

Saulius K. Girnius, Saem Lee, Suman Kambhampati, Michal G. Rose, Abid Mohiuddin, Antoun Houranieh, Abraham Zimelman, Terrence Grady, Paulette Mehta, Caroline Behler, Teresa G. Hayes, Yvonne A. Efebera, Rao H. Prabhala, Andrew Han, Sarvari V. Yellapragada, Catherine E. Klein, G. David Roodman, Alan Lichtenstein, Nikhil C. Munshi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Once-weekly administration of bortezomib has reduced bortezomib-induced peripheral neuropathy without affecting response rates, but this has only been demonstrated prospectively in three- and four- drug combinations. We report a phase II trial of alternate dosing and schedule of bortezomib and dexamethasone in newly diagnosed multiple myeloma patients who are not eligible for or refused autologous stem cell transplantation. Bortezomib 1·6 mg/m2 intravenously was given once-weekly for six cycles, together with dexamethasone 40 mg on the day of and day after bortezomib. Fifty patients were enrolled; 58% did not require any dose modification. The majority of patients had multiple co-morbidities, including cardiovascular (76%) and renal insufficiency (54%), and the median number of medications prior to enrollment was 13. Of all evaluable patients, the overall response rate was 79% and at least 45% had at least a very good partial response. The median time to first response was 1·3 months (range, 0·25-2·4 months). The progression-free and overall survivals were 8 months and 46·5 months, respectively. Twenty-four percent developed worsening neuropathy. We conclude that alternate dosing and scheduling of bortezomib and dexamethasone is both safe and effective for management of newly diagnosed multiple myeloma in frail patients.

Original languageEnglish
Pages (from-to)36-43
Number of pages8
JournalBritish Journal of Haematology
Volume169
Issue number1
DOIs
StatePublished - Apr 1 2015

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Stem Cell Transplantation
Veterans
Multiple Myeloma
Dexamethasone
Peripheral Nervous System Diseases
Drug Combinations
Disease-Free Survival
Renal Insufficiency
Bortezomib
Appointments and Schedules
Morbidity

Keywords

  • Bortezomib
  • Co-morbidities
  • Multiple myeloma
  • Transplant ineligible

ASJC Scopus subject areas

  • Hematology
  • Medicine(all)

Cite this

A Phase II trial of weekly bortezomib and dexamethasone in veterans with newly diagnosed multiple myeloma not eligible for or who deferred autologous stem cell transplantation. / Girnius, Saulius K.; Lee, Saem; Kambhampati, Suman; Rose, Michal G.; Mohiuddin, Abid; Houranieh, Antoun; Zimelman, Abraham; Grady, Terrence; Mehta, Paulette; Behler, Caroline; Hayes, Teresa G.; Efebera, Yvonne A.; Prabhala, Rao H.; Han, Andrew; Yellapragada, Sarvari V.; Klein, Catherine E.; Roodman, G. David; Lichtenstein, Alan; Munshi, Nikhil C.

In: British Journal of Haematology, Vol. 169, No. 1, 01.04.2015, p. 36-43.

Research output: Contribution to journalArticle

Girnius, SK, Lee, S, Kambhampati, S, Rose, MG, Mohiuddin, A, Houranieh, A, Zimelman, A, Grady, T, Mehta, P, Behler, C, Hayes, TG, Efebera, YA, Prabhala, RH, Han, A, Yellapragada, SV, Klein, CE, Roodman, GD, Lichtenstein, A & Munshi, NC 2015, 'A Phase II trial of weekly bortezomib and dexamethasone in veterans with newly diagnosed multiple myeloma not eligible for or who deferred autologous stem cell transplantation', British Journal of Haematology, vol. 169, no. 1, pp. 36-43. https://doi.org/10.1111/bjh.13243
Girnius, Saulius K. ; Lee, Saem ; Kambhampati, Suman ; Rose, Michal G. ; Mohiuddin, Abid ; Houranieh, Antoun ; Zimelman, Abraham ; Grady, Terrence ; Mehta, Paulette ; Behler, Caroline ; Hayes, Teresa G. ; Efebera, Yvonne A. ; Prabhala, Rao H. ; Han, Andrew ; Yellapragada, Sarvari V. ; Klein, Catherine E. ; Roodman, G. David ; Lichtenstein, Alan ; Munshi, Nikhil C. / A Phase II trial of weekly bortezomib and dexamethasone in veterans with newly diagnosed multiple myeloma not eligible for or who deferred autologous stem cell transplantation. In: British Journal of Haematology. 2015 ; Vol. 169, No. 1. pp. 36-43.
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AU - Rose, Michal G.

AU - Mohiuddin, Abid

AU - Houranieh, Antoun

AU - Zimelman, Abraham

AU - Grady, Terrence

AU - Mehta, Paulette

AU - Behler, Caroline

AU - Hayes, Teresa G.

AU - Efebera, Yvonne A.

AU - Prabhala, Rao H.

AU - Han, Andrew

AU - Yellapragada, Sarvari V.

AU - Klein, Catherine E.

AU - Roodman, G. David

AU - Lichtenstein, Alan

AU - Munshi, Nikhil C.

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