This study compared the safety and efficacy of a new regimen—bortezomib plus dexamethasone and vincristine— compared with vincristine (Oncovin), doxorubicin (Adriamycin), and dexamethasone (VAD) in previously untreated multiple myeloma (MM) (J Clin Oncol. 2010;28:4621-4629).
This phase 3 study randomized 482 patients to VAD (n = 121), VAD plus dexamethasone, cyclophosphamide (Endoxan), etoposide (Eposin), and cisplatin (Platinol; DCEP) consolidation (n = 121), bortezomib plus dexamethasone (n = 121), or bortezomib plus dexamethasone plus DCEP (n = 119), followed by autologous stem-cell transplantation. The primary end point was postinduction complete/near-complete response (CR/nCR) rate.
The rates of postinduction CR/nCR (14.8% vs 6.4%), at least very good partial response (37.7% vs 15.1%), and overall response (78.5% vs 62.8%) were significantly higher with bortezomib plus dexamethasone versus VAD.
Bortezomib plus dexamethasone should now be considered a standard induction treatment before transplantation, say the authors.
