The effects of different schedules of bortezomib, melphalan, and prednisone for patients with newly diagnosed multiple myeloma who are transplant ineligible: a matching-adjusted indirect comparison
Maria-Victoria Mateos 1 , Jesus San-Miguel 2 , Hartmut Goldschmidt 3 , Pieter Sonneveld 4 , Meletios A Dimopoulos 5 , Bart Heeg 6 , Mahmoud Hashim 6 , William Deraedt 7 , Peter Hu 8 , Annette Lam 9 , Jianming He 9
For patients with newly diagnosed multiple myeloma (NDMM) who are transplant ineligible, bortezomib-melphalan-prednisone (VMP) demonstrated superior efficacy based on the VISTA trial. In subsequent trials, twice-weekly bortezomib was limited to the first cycle or completely replaced with once-weekly bortezomib to reduce toxicity.
Following a systematic literature review, the efficacy and safety of modified VMP schedules (pooled data from the once-weekly bortezomib VMP arm of the GIMEMA trial and the VMP arm of the ALCYONE trial) were compared to the VISTA schedule using naïve and unanchored matching-adjusted indirect comparison (MAIC).
Median progression-free survival was similar between VISTA and modified VMP (20.7 months [95% CI, 18.4-24.3] vs 19.6 months [95% CI, 18.8-21.0]). Peripheral neuropathy was significantly reduced with modified VMP versus VISTA VMP (all grades: naïve, 32.1% vs 46.8% and MAIC, 32.1% vs 46.7%; both p < .0001).
These findings support a modified VMP dosing schedule for patients with NDMM who are transplant ineligible.
CITATION Leuk Lymphoma. 2020 Mar;61(3):680-690. doi: 10.1080/10428194.2019.1675881. Epub 2019 Nov 5.