A phase III study of VMPT versus VMP in newly diagnosed elderly myeloma patients

Article

A phase III study of VMPT versus VMP in newly diagnosed elderly myeloma patients

A phase III study of VMPT versus VMP in newly diagnosed elderly myeloma patients

A.P. Palumbo, S. Bringhen, D. Rossi, et al

Methods: The present trial randomized 500 newly diagnosed multiple myeloma (MM) patients ≥ 65 years to either VMPT or VMP. Patients were treated with nine 5-week cycles of VMPT (bortezomib [Velcade] 1.3 mg/m2 days 1, 8, 15, 22; melphalan 9 mg/m2 days 1-4; prednisone 60 mg/m2 days 1-4, and thalidomide 50 mg days 1-35) or VMP (bortezomib, melphalan, and prednisone at the same doses and schedules previously described). The primary end point was progression-free survival (PFS).

Results: Among 354 evaluable patients (median age 71) receiving at least 1 cycle, PFS at 3 years was 71% in the VMPT group and 56% in the VMP group (P = .13). Overall survival at 3 years was 90% in the VMPT group and 89% in the VMP group (P = .81). Complete responses were reported in 35% of patients in the VMPT group and 21% in the VMP group, which was a highly significant difference (P < .0001).

Grade 3/4 peripheral neuropathy (among patients who received weekly infusion of bortezomib) was 2%/3% in the VMPT/VMP groups, respectively. Also, discontinuations for peripheral neuropathy were similar at 3%/4% for VMPT/VMP. Rates of peripheral neuropathy and discontinuation were both markedly lower with the weekly infusion than for twice-weekly infusion.

Conclusions: The four-drug combination as compared with the three-drug combination increased the CR rate significantly. There was a numerical increase in PFS but this was not statistically significant. Longer follow-up is needed to assess the effects on PFS and OS.

Recent Videos
Stacey A. Cohen, MD, and Daniel H. Ahn, DO, presenting slides
Stacey A. Cohen, MD, and Daniel H. Ahn, DO, presenting slides
Experts from Vanderbilt University Medical Center emphasize gathering a second opinion to determine if a tumor is resectable in patients with pancreatic cancer.
A panel of 4 experts on multiple myeloma
A panel of 4 experts on multiple myeloma
Experts from Vanderbilt University Medical Center discuss the use of intraoperative radiation therapy in a 64-year-old patient with pancreatic cancer.
Balazs Halmos, MD, with the Oncology Brothers presenting slides
Balazs Halmos, MD, with the Oncology Brothers presenting slides
Balazs Halmos, MD, with the Oncology Brothers presenting slides
Balazs Halmos, MD, with the Oncology Brothers presenting slides
Related Content