Bortezomib retreatment is effective in relapsed multiple myeloma patients – real-life clinical practice data

Martin Štork, Sabina Ševčíková, Lucie Brožová, Ivan Špička, Vladimír Maisnar, Jiří Minařík, Alexandra Jungová, Evžen Gregora, Roberta Velichová, Roman Hájek, Tomáš Jelínek,  Luděk Pour

Abstract:

Nowadays, bortezomib, a proteasome inhibitor, is widely used in treatment of newly diagnosed or relapsed multiple myeloma. The aim of this study was to analyze efficiency of bortezomib retreatment in patients with relapsed or refractory multiple myeloma. From 2004 to 2016, 283 patients were retrospectively evaluated at all hematological centers in the Czech Republic. Bortezomib was administered at the standard dosing and in combined therapy with corticosteroids, chemotherapy or thalidomide. Before bortezomib retreatment, 61% of patients received previous lenalidomide treatment, 40.6% autologous transplantation, and median number of prior lines of therapy was three. In total, 21% of patients were refractory to the first bortezomib treatment. In bortezomib retreatment, overall response rate was 34.5%, median progression-free survival was 7.8 months (95% CI: 6.7–8.9), median duration of response was 10.5 months (95% CI: 8.0–13.0) and median overall survival was 20.3 months (95% CI: 17.9–22.7). Grade 3-4 adverse events included thrombocytopenia, neutropenia, anemia and infection. Neuropathy grade 2 or higher occurred in 19.4% of patients. We conclude that bortezomib retreatment is an effective and safe therapeutic alternative for relapsed or refractory multiple myeloma patients.