Weekly bortezomib/methylprednisolone is effective and well tolerated in relapsed multiple myeloma

Attaya Suvannasankha, Gina G. Smith, Beth E. Juliar, Rafat Abonour

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Background: The standard schedule of bortezomib requires frequent infusions and is often associated with dose-dependent, adverse effects such as sensory neuropathy and thrombocytopenia. Because of the known additive effect between bortezomib and glucocorticoid, we explored weekly bortezomib/methylprednisolone in patients with relapsed multiple myeloma. Patients and Methods: Twenty-nine patients were treated at Indiana University with bortezomib (1.3 mg/m2) and methylprednisolone (500-2000 mg) intravenously on days 1, 8, and 15 of 28-day cycles. Response was evaluated using the Bladé criteria. Twenty-one patients (70%) had previous stem cell transplantation, and 13 were in third relapse or higher. Results: A response was observed in 18 patients (62%): 1 (3%) complete response, 1 (3%) near complete response, and 16 (55%) partial responses. Six (21%) had stable disease, and 5 (17%) had disease progression. The median time to progression, which was defined from the beginning of therapy until progression, was 6.6 months (95% confidence interval, 6.4-9.2 months). The median number of treatment cycles was 6 (range, 2-12 cycles). The median overall survival was 20.2 months (lower 95% confidence interval, 13.1 months). The most common toxicities were fatigue and gastrointestinal disturbances. Grade ≥ 3 adverse effects included neuropathy (2 grade 3), gastrointestinal side effects (1 grade 3), and congestive heart failure (1 grade 3). Conclusion: The weekly bortezomib/methylprednisolone regimen was well tolerated and yielded a response rate comparable with the standard schedule of bortezomib alone. Our data support further investigation of this regimen in larger patient cohorts.

Original languageEnglish
Pages (from-to)131-134
Number of pages4
JournalClinical Lymphoma and Myeloma
Volume7
Issue number2
StatePublished - Sep 2006

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Methylprednisolone
Multiple Myeloma
Appointments and Schedules
Confidence Intervals
Stem Cell Transplantation
Thrombocytopenia
Glucocorticoids
Fatigue
Disease Progression
Bortezomib
Heart Failure
Recurrence
Survival
Therapeutics

Keywords

  • Antineoplastic combined chemotherapy protocols
  • Proteasome
  • Salvage therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Hematology

Cite this

Weekly bortezomib/methylprednisolone is effective and well tolerated in relapsed multiple myeloma. / Suvannasankha, Attaya; Smith, Gina G.; Juliar, Beth E.; Abonour, Rafat.

In: Clinical Lymphoma and Myeloma, Vol. 7, No. 2, 09.2006, p. 131-134.

Research output: Contribution to journalArticle

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abstract = "Background: The standard schedule of bortezomib requires frequent infusions and is often associated with dose-dependent, adverse effects such as sensory neuropathy and thrombocytopenia. Because of the known additive effect between bortezomib and glucocorticoid, we explored weekly bortezomib/methylprednisolone in patients with relapsed multiple myeloma. Patients and Methods: Twenty-nine patients were treated at Indiana University with bortezomib (1.3 mg/m2) and methylprednisolone (500-2000 mg) intravenously on days 1, 8, and 15 of 28-day cycles. Response was evaluated using the Blad{\'e} criteria. Twenty-one patients (70{\%}) had previous stem cell transplantation, and 13 were in third relapse or higher. Results: A response was observed in 18 patients (62{\%}): 1 (3{\%}) complete response, 1 (3{\%}) near complete response, and 16 (55{\%}) partial responses. Six (21{\%}) had stable disease, and 5 (17{\%}) had disease progression. The median time to progression, which was defined from the beginning of therapy until progression, was 6.6 months (95{\%} confidence interval, 6.4-9.2 months). The median number of treatment cycles was 6 (range, 2-12 cycles). The median overall survival was 20.2 months (lower 95{\%} confidence interval, 13.1 months). The most common toxicities were fatigue and gastrointestinal disturbances. Grade ≥ 3 adverse effects included neuropathy (2 grade 3), gastrointestinal side effects (1 grade 3), and congestive heart failure (1 grade 3). Conclusion: The weekly bortezomib/methylprednisolone regimen was well tolerated and yielded a response rate comparable with the standard schedule of bortezomib alone. Our data support further investigation of this regimen in larger patient cohorts.",
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N2 - Background: The standard schedule of bortezomib requires frequent infusions and is often associated with dose-dependent, adverse effects such as sensory neuropathy and thrombocytopenia. Because of the known additive effect between bortezomib and glucocorticoid, we explored weekly bortezomib/methylprednisolone in patients with relapsed multiple myeloma. Patients and Methods: Twenty-nine patients were treated at Indiana University with bortezomib (1.3 mg/m2) and methylprednisolone (500-2000 mg) intravenously on days 1, 8, and 15 of 28-day cycles. Response was evaluated using the Bladé criteria. Twenty-one patients (70%) had previous stem cell transplantation, and 13 were in third relapse or higher. Results: A response was observed in 18 patients (62%): 1 (3%) complete response, 1 (3%) near complete response, and 16 (55%) partial responses. Six (21%) had stable disease, and 5 (17%) had disease progression. The median time to progression, which was defined from the beginning of therapy until progression, was 6.6 months (95% confidence interval, 6.4-9.2 months). The median number of treatment cycles was 6 (range, 2-12 cycles). The median overall survival was 20.2 months (lower 95% confidence interval, 13.1 months). The most common toxicities were fatigue and gastrointestinal disturbances. Grade ≥ 3 adverse effects included neuropathy (2 grade 3), gastrointestinal side effects (1 grade 3), and congestive heart failure (1 grade 3). Conclusion: The weekly bortezomib/methylprednisolone regimen was well tolerated and yielded a response rate comparable with the standard schedule of bortezomib alone. Our data support further investigation of this regimen in larger patient cohorts.

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