Can the addition of bortezomib improve treatment results long-term for patients with multiple myeloma?

This study examined if the addition of bortezomib (Velcade) to treatment with lenalidomide (Revlimid) and dexamethasone (Decadron) could improve treatment results long-term for patients with multiple myeloma (MM). The authors found that patients who received bortezomib had a longer survival long-term.

Lenalidomide and dexamethasone are often used to treat patients with newly diagnosed MM. These drugs work by interfering with the growth of MM cells. Bortezomib is a more recent therapy that interferes with MM cells in a different way and compliments lenalidomide and dexamethasone. Previous studies have shown that bortezomib, lenalidomide, and dexamethasone (BLD) gives better treatment results than lenalidomide and dexamethasone (LD) alone. It is unclear if these results continue long-term.

460 patients with MM were divided into two groups. 235 patients received BLD and 225 patients received LD. Patients’ results were recorded for an average of 84 months.

Patients had a 26% higher chance of survival without cancer worsening with BLD treatment. Patients who received BLD survived for 41 months without cancer worsening compared to 29 months for patients who received LD. 

Patients who received BLD had a 29.1% higher chance of longer survival compared to LD. Patients survived for 69 months on average after LD treatment. The average survival following BLD treatment was not reached by the end of this study but is over 84 months. It was estimated that after 5 years, 69% of patients who received BLD and 56% of patients who received LD had survived.

90.2% of patients responded (had a reduction in MM) to BLD treatment and 78.8% to LD. 24.2% of patients had no signs of cancer after BLD treatment compared with 12.1% of patients after LD treatment. The effects of BLD treatment lasted for 50 months, while the effects of LD lasted 39 months.

34.6% of the BLD group and 11.3% of the LD group developed serious side effects. The most common side effects were low blood cell counts and infections.

The authors concluded that patients who received BLD had significantly better treatment results than LD.

The manufacturer of bortezomib, Takeda, and lenalidomide, Celgene, partially funded this study.