Publicaciones científicas

Effect of cumulative bortezomib dose on survival in multiple myeloma patients receiving bortezomib-melphalan-prednisone in the phase III VISTA study.

Mateos M (1), Richardson PG, Dimopoulos MA, Palumbo A, Anderson KC, Shi H, Elliott J, Dow E, van de Velde H, Niculescu L, San Miguel JF.
(1) Hospital Universitario Salamanca, Instituto Biosanitario de Salamanca (IBSAL), Spain.

Revista: American Journal of Hematology

Fecha: 02/01/2015

Hematología y Hemoterapia


This analysis, using data from the bortezomib-melphalan-prednisone (VMP) arm of the Phase III VISTA study, investigated whether increased cumulative bortezomib dose could improve overall survival (OS) in transplant-ineligible patients with previously untreated multiple myeloma.

Median cumulative bortezomib dose received by the 340 patients was 39 mg/m2 ; this was selected as the cut-off for defining the dose groups to be compared for OS.

Patient characteristics were well balanced between dose groups except for age. OS was significantly longer in the higher (≥39 mg/m2 ) versus lower (<39 mg/m2 ) cumulative bortezomib dose group (median 66.3 vs. 46.2 months; hazard ratio [HR] 0.533, P < 0.0001; age-adjusted HR 0.561, P = 0.0002).

To overcome confounding effects of early discontinuations/deaths, which were more common in the lower cumulative dose group (27% vs 4% of patients discontinued due to adverse events in the lower and higher cumulative dose groups, respectively), a landmark analysis was conducted at 180 days, eliminating patients who died or discontinued before this time from the analysis. OS from this landmark remained significantly longer in the higher dose group (median 60.4 vs. 50.3 months; HR 0.709, P = 0.0372).

Thus, higher cumulative bortezomib dose, reflecting prolonged treatment duration and/or dose intensity, appears associated with improved OS.

Approaches to achieve higher cumulative doses could include subcutaneous bortezomib administration, dose/schedule modifications, continuing therapy in responding patients, and proactive adverse event management.

CITA DEL ARTÍCULO Am J Hematol. 2015 Jan 2. doi: 10.1002/ajh.23933.



La Clínica es el hospital privado con mayor dotación tecnológica de España, todo en un único centro.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra


Los profesionales de la Clínica realizan una labor continuada de investigación y formación, siempre en beneficio del paciente.

Imagen profesionales de la Clínica Universidad de Navarra


Conozca por qué somos diferentes a otros centros sanitarios. Calidad, rapidez, comodidad y resultados.

Imagen del edificio de la Clínica Universidad de Navarra