Contributions
Abstract: PB1993
Type: Publication Only
Background
Although bortezomib-melphalan-prednisone (VMP) therapy is a well-established standard treatment for patients with multiple myeloma (MM) who are ineligible for high-dose therapy, it is not clear whether very elderly patients should be treated with VMP in clinical practice, considering the toxicities.
Aims
The purpose of this case-control study was to compare the efficacy of VMP versus melphalan-prednisone or cyclophosphamide-prednisone (MP/CP) as initial therapy for very elderly patients.
Methods
We retrospectively studied 233 patients aged 75 years or older with newly diagnosed multiple myeloma between March 2007 and February 2015. One-hundred thirty one patients received VMP and 102 patients received MP/CP regimen were enrolled from 15 institutions throughout Korea.
Results
Patient characteristics were comparable in these two groups. Overall response rate was 70.2% in VMP patients and 48.0% in MP/CP patients (P=0.001). Complete response rate was 22.9% in VMP patients and 7.8% in MP/CP patients (P=0.002). After a median follow-up for survivors of 28.5 months, progression-free survival (PFS) and overall survival (OS) were significantly different between the two groups (PFS, median 21.3 vs. 11.8 months in VMP and MP/CP group, respectively, P=0.018; OS, median 34.9 vs. 22.8 months in VMP and MP/CP group, respectively, P = 0.006). Nonetheless, for 61 patients who were aged ≥ 80 years, PFS and OS was not significantly different between the two groups (PFS, median 19.6 vs. 13.2 months in VMP and MP/CP group, respectively, P=0.378; OS, median 27.8 vs.17.8 months in VMP and MP/CP group, respectively, P = 0.443).
Conclusion
Although VMP therapy was associated with a significant improvement in overall survival among patients ≥75 years, there is no differences for patients aged 80 or older. Frailty and comprehensive geriatric assessment should be incorporated to guide treatment decisions for this population.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, Elderly, bortezomib, prognosis
Abstract: PB1993
Type: Publication Only
Background
Although bortezomib-melphalan-prednisone (VMP) therapy is a well-established standard treatment for patients with multiple myeloma (MM) who are ineligible for high-dose therapy, it is not clear whether very elderly patients should be treated with VMP in clinical practice, considering the toxicities.
Aims
The purpose of this case-control study was to compare the efficacy of VMP versus melphalan-prednisone or cyclophosphamide-prednisone (MP/CP) as initial therapy for very elderly patients.
Methods
We retrospectively studied 233 patients aged 75 years or older with newly diagnosed multiple myeloma between March 2007 and February 2015. One-hundred thirty one patients received VMP and 102 patients received MP/CP regimen were enrolled from 15 institutions throughout Korea.
Results
Patient characteristics were comparable in these two groups. Overall response rate was 70.2% in VMP patients and 48.0% in MP/CP patients (P=0.001). Complete response rate was 22.9% in VMP patients and 7.8% in MP/CP patients (P=0.002). After a median follow-up for survivors of 28.5 months, progression-free survival (PFS) and overall survival (OS) were significantly different between the two groups (PFS, median 21.3 vs. 11.8 months in VMP and MP/CP group, respectively, P=0.018; OS, median 34.9 vs. 22.8 months in VMP and MP/CP group, respectively, P = 0.006). Nonetheless, for 61 patients who were aged ≥ 80 years, PFS and OS was not significantly different between the two groups (PFS, median 19.6 vs. 13.2 months in VMP and MP/CP group, respectively, P=0.378; OS, median 27.8 vs.17.8 months in VMP and MP/CP group, respectively, P = 0.443).
Conclusion
Although VMP therapy was associated with a significant improvement in overall survival among patients ≥75 years, there is no differences for patients aged 80 or older. Frailty and comprehensive geriatric assessment should be incorporated to guide treatment decisions for this population.
Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical
Keyword(s): Myeloma, Elderly, bortezomib, prognosis