In a nutshell
This study investigated whether a combination of bortezomib (Velcade), melphalan (Alkeran) and prednisone (Deltasone) was more effective than lenalidomide (Revlimid) and dexamethasone (Decadron) followed by lenalidomide maintenance for newly diagnosed multiple myeloma (MM). The main finding was that age and disease risk influenced the effectiveness of these treatments.
Some background
Bortezomib, melphalan, plus prednisone (VMP) and lenalidomide with dexamethasone (Rd) are commonly used regimes for newly diagnosed MM. Different combinations of treatments have different effects on different patients. Up to now, no study has compared the effectiveness of these combinations in newly diagnosed MM. It is important to investigate which strategy works better.
Two common measures used to see how well anti-cancer drugs work are progression-free survival and overall survival. Progression-free survival is the length of time during and after the treatment of cancer that a patient lives with the disease without it worsening. Overall survival is the length of time from the start of treatment that the patients are still alive.
Methods & findings
This study compared the results of two trials. 257 patients treated with VMP were included in the first study. 217 patients treated with Rd were included in the second study. The main outcomes compared were progression-free survival (PFS) and overall survival (OS).
There was no difference in PFS and OS for standard-risk patients on either treatment combination. In high-risk patients, those treated with VMP were 46% less likely to experience progression. In the same patients, those treated with VMP were 27% more likely to survive. Patients with standard-risk MM over the age of 75 were 81% more likely to survive when treated with Rd compared to VMP.
The bottom line
This study concluded that the two regimens were similarly effective in standard-risk patients. However, VMP is more effective in high-risk patients and Rd in elderly patients.
The fine print
This study compared the results from two different trials. The analysis of results by different investigators may have affected their reliability.
Published By :
Haematologica
Date :
Jun 27, 2019
