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Original article

Vol. 142 No. 1718 (2012)

Effective response with bortezomib retreatment in relapsed multiple myeloma

  • Christian Taverna
  • Jérôme Voegeli
  • Andreas Trojan
  • Robert A Olie
  • Albert von Rohr
DOI
https://doi.org/10.4414/smw.2012.13562
Cite this as:
Swiss Med Wkly. 2012;142:w13562
Published
22.04.2012

Abstract

Previous studies have shown that retreatment of relapsed/refractory multiple myeloma (MM) with a second course of bortezomib therapy could be effective in heavily pre-treated patients. In this study, the results of a multicentre, retrospective survey were reported involving patients in Switzerland with MM who responded to initial bortezomib therapy; 43 patients were enrolled and 42 were evaluated for response. The overall response rate (complete response [CR] + near CR [nCR] + partial response [PR]) to bortezomib retreatment was 64.3%, and the clinical benefit rate (CR + nCR + PR + stable disease) for retreatment was 83%. The response rate to bortezomib retreatment in the subgroup with a first treatment-free interval (TFI) >6 months was higher than that in the subgroup with first TFI ≤6 months (74.1% vs. 46.7%) and lower in patients who received concomitant dexamethasone with bortezomib retreatment (57.1% vs. 78.6%). The median overall survival (OS) from first diagnosis of MM was 9.3 years, and after retreatment with bortezomib the median OS was 1.7 years. In total, 85.7% of patients who achieved CR or nCR with initial bortezomib treatment achieved CR or nCR with retreatment. Bortezomib as retreatment was well tolerated, and the safety profile was consistent with previous studies of bortezomib in relapsed MM. The most common adverse drug reaction attributed to bortezomib was peripheral neuropathy in 5 patients. In conclusion, bortezomib retreatment was a well-tolerated, effective therapeutic option for relapsed MM patients in the Swiss clinical setting who have previously responded to bortezomib, particularly for those who experienced an initial TFI of >6 months.

References

  1. Kumar SK, Therneau TM, Gertz MA, et al. Clinical course of patients with relapsed multiple myeloma. Mayo Clin Proc. 2004;79:867–74.
  2. Taverna C, Bargetzi M, Betticher D, et al. Integrating novel agents into multiple myeloma treatment – current status in Switzerland and treatment recommendations. Swiss Med Wkly. 2010;140:w13054.
  3. Conner TM, Doan QD, Walters IB, LeBlanc AL, Beveridge RA. An observational, retrospective analysis of retreatment with bortezomib for multiple myeloma. Clin Lymphoma Myeloma. 2008;8:140–5.
  4. Wolf J, Richardson PG, Schuster M, LeBlanc A, Walters IB, Battleman DS. Utility of bortezomib retreatment in relapsed or refractory multiple myeloma patients: a multicenter case series. Clin Adv Hematol Oncol. 2008;6:755–60.
  5. Hrusovsky I, Emmerich B, von RA, et al. Bortezomib retreatment in relapsed multiple myeloma – Results from a retrospective multicentre survey in Germany and Switzerland. Oncology. 2011;79:247–54.
  6. Petrucci MT, Blau I, Corradini P, et al. Efficacy and safety of retreatment with bortezomib in patients with multiple myeloma: Interim results from RETRIEVE, a prospective international phase 2 study. 95 (Suppl 2). Abstract 0377 ed. 2010.
  7. Ciolli S, Leoni F, Casini C, Bosi A. Feasibility and efficacy of bortezomib re-treatment in multiple myeloma. Haematologica. 2007;92:Abstract 0260.
  8. Rubio-Martinez A, Recasens V, Soria B, Montanes MA, Rubio-Escuin R, Giraldo P. Response to retreatment on relapse multiple myeloma patients previously treated with bortezomib. Haematologica 2008;93:Abstract 0649.
  9. Sood R, Carloss H, Kerr R, et al. Retreatment with bortezomib alone or in combination for patients with multiple myeloma following an initial response to bortezomib. Am J Hematol. 2009;84:657–60.
  10. Mohty B, El-Cheikh J, Yakoub-Agha I, Avet-Loiseau H, Moreau P, Mohty M. Treatment strategies in relapsed and refractory multiple myeloma: a focus on drug sequencing and “retreatment” approaches in the era of novel agents. Leukemia. 2012;26:73–85.
  11. Velcade. Summary of product characteristics EMEA Janssen-Cilag International NV. Summary of product characteristics 2010.
  12. Drewinko B, Alexanian R, Boyer H, Barlogie B, Rubinow SI. The growth fraction of human myeloma cells. Blood. 1981;57:333–8.
  13. Gottesman MM. Mechanisms of cancer drug resistance. Annu Rev Med. 2002;53:615–27.
  14. Mateos MV, Richardson PG, Schlag R, et al. Bortezomib plus melphalan and prednisone compared with melphalan and prednisone in previously untreated multiple myeloma: updated follow-up and impact of subsequent therapy in the phase III VISTA trial. J Clin Oncol. 2010;28:2259–66.
  15. Richardson PG, Sonneveld P, Schuster MW, et al. Reversibility of symptomatic peripheral neuropathy with bortezomib in the phase III APEX trial in relapsed multiple myeloma: impact of a dose-modification guideline. Br J Haematol. 2009;144:895–903.
  16. Bringhen S, Larocca A, Rossi D, et al. Efficacy and safety of once-weekly bortezomib in multiple myeloma patients. Blood. 2010;116:4745–53.
  17. Mateos MV, Oriol A, Martinez-Lopez J, et al. Bortezomib, melphalan, and prednisone versus bortezomib, thalidomide, and prednisone as induction therapy followed by maintenance treatment with bortezomib and thalidomide versus bortezomib and prednisone in elderly patients with untreated multiple myeloma: a randomised trial. Lancet Oncol. 2010;11:934–41.
  18. Moreau P, Pylypenko H, Grosicki S, et al. Subcutaneous versus intravenous administration of bortezomib in patients with relapsed multiple myeloma: a randomised, phase 3, non-inferiority study. Lancet Oncol. 2011;12:431–40.

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