Primary failure of bortezomib in newly diagnosed multiple myeloma-understanding the magnitude, predictors, and significance


Cohen YC, Joffe E, Benyamini N, Dimopoulos MA, Terpos E, Trestman S, Held-Kuznetsov V, Avivi I, Kastritis E. Primary failure of bortezomib in newly diagnosed multiple myeloma-understanding the magnitude, predictors, and significance. Leukemia and Lymphoma [Internet]. 2016;57(6):1382 - 1388.


Botezomib-based induction is highly effective for the treatment of newly diagnosed multiple myeloma (NDMM). We investigated the outcomes of NDMM patients who failed to respond to bortezomib-based induction in a real-life clinical setting. In a cohort of 295 consecutive NDMM patients in 3 medical centers, 74 (25%) failed to achieve at least partial response after 4 induction cycles, and were classified as non-responsive. Compared to induction responders, they were older, more frequently anemic, had a higher incidence of del17p and ISS-3, and a worse performance status. In multivariable analysis, bortezomib-based induction failure occurred in 25% of patients and was the strongest independent factor predicting mortality with a 5-fold hazard ratio (95% CI 1.44-8.68). Three-year overall survival in responsive vs. non-responsive patients were 76% vs. 53%, respectively (p < 0.0001). Survival from time of salvage second-line treatment was significantly shorter among induction non-responders vs. responders (25 months vs. not-reached, p = 0.024). © 2015 Taylor & Francis.


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