Efficacy comparison between standard and reduced doses of bortezomib combination therapy in the treatment of multiple myeloma / 中国医师进修杂志

ABSTRACT

Objective To compare the efficacy and safety of standard or reduced doses of bortezomib combined with adriamycin and dexamethasone in patients with multiple myeloma (MM).Methods Fifty-two newly diagnosed,refractory and relapsed patients received bortezomib [1.3 mg/m2 (standard dose group,26 patients) or 1.0-1.1 mg/m2 (reduced dose group,26 patients) on day 1st,4th,8th and 11 th],and adriamycin (10 mg/m2) plus dexamethasone (40 mg/d) on day 1 st-4th,and were treated for 1-6 courses.Adverse events were graded and compared.Results After treatment,the overall response rate of standard dose group [80.8％(21/26)] and reduced dose group [88.5％(23/26)] had no significant difference (P =0.739).The rate of neutropenia and thrombocytopenia in two groups had no significant difference[23.1％(6/26) vs.15.4％(4/26),P=0.281 ; 11.5％(3/26) vs.7.7％(2/26),P=0.620].The rate of Ⅲ-Ⅳ grade peripheral nerve disease,herpes zoster,lack of power and abdominal distension in standard dose group were significantly higher than those in reduced dose group [15.4％(4/26) vs.3.8％(1/26),P =0.038;26.9％(7/26) vs.7.7％(2/26),P =0.029;38.5％(10/26) vs.15.4％(4/26),P=0.045; 19.2％(5/26)vs.3.8％ (1/26),P =0.028].Conclusion Reduced dose of bortezomib appears to result in similar overall response rate,but better tolerance and safety compared with standard dose.