Tolerance, Kinetics, and Depth of Response for Subcutaneous Versus Intravenous Administration of Bortezomib Combination in Chinese Patients With Newly Diagnosed Multiple Myeloma

Xu, Yan; Deng, Shuhui; Mao, Xuehan; An, Gang; Li, Zengjun; Fulciniti, Mariateresa; Ho, Matthew; Lin, Jianhong; Sui, Weiwei; Liu, Wei; Zou, Dehui; Yi, Shuhua; Huang, Wenyang; Liu, Hong; Lv, Rui; Li, Jian; Du, Chenxing; Munshi, Nikhil C.; Qiu, Lugui

doi:10.1016/j.clml.2018.03.006

Cited by 8 publications

(5 citation statements)

References 30 publications

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“…This indicates that the IV injection group exhibited a faster response and deeper remission degree, when compared with the SC injection group. With the increase of the course of treatment, the effect was basically the same, which is basically consistent with the results of the retrospective study conducted by Xu et al19…”

Section: Discussionsupporting

confidence: 91%

<p>Analysis of the efficacy and safety of bortezomib for treating newly diagnosed multiple myeloma through different administration methods</p>

Zhang

Liu

et al. 2019

CMAR

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BackgroundThis study aims to compare the efficacy and adverse reactions of bortezomib for treating newly diagnosed multiple myeloma (MM) through two different administration methods: intravenous (IV) injection and subcutaneous (SC) injection.MethodsA retrospective analysis was performed in 205 patients with newly diagnosed MM, who were treated by the Department of Hematopathology, Henan Cancer Hospital, from June 2009 to December 2017. These patients were divided into two groups according to the treatment methods: IV injection group, IV injection of bortezomib; SC injection group, SC injection of bortezomib.ResultsAfter the first course of treatment, the effect of very good partial remission (VGPR) or above (≥VGPR) in the IV injection group (IV group) and SC injection group (SC group) was 31.0% and 14.3%, respectively (P=0.004), while the overall response rate (ORR) was 72.0% and 49.5%, respectively (P=0.001). From the 2nd course to the 6th course of treatment, the ORR was not statistically different between these two groups. No significant difference was found in median progression-free survival (37 vs 45 months) and overall survival (63 vs 59 months). A lower frequency of adverse events, especially Grade 3 peripheral neuropathy, was observed in SC group compared with the IV group.ConclusionCompared with IV administration, SC bortezomib can provide a better balance between efficacy and toxicity.

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Section: Discussionsupporting

confidence: 91%

<p>Analysis of the efficacy and safety of bortezomib for treating newly diagnosed multiple myeloma through different administration methods</p>

Zhang

Liu

et al. 2019

CMAR

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“…Studies have shown that PTD regimen (PD regimen combined with thalidomide) achieved promising results, with CR/nCR of 30 ∼ 50%, adverse reactions tolerable, and grade 3/4 PN of about 15%, thus it is considered to be one of the best triplet regimens for MM from the economic perspective and adverse reaction concerns (Cavo et al, 2010;Ludwig et al, 2013;Huang et al, 2014;Leiba et al, 2014;Gentile et al, 2017;Blommestein et al, 2019). However, based on our practice, PTD is poorly tolerated, with a PN incidence of more than 80%, and nearly 50% of patients developed grade 2/3 PN (He et al, 2014).This may be partly due to the fact that patients in the before-2013 group were all treated with bortezomib by IV, while the incidence and severity of PN are significantly higher in the patients treated with bortezomib by IV compared to that by SC Arnulf et al, 2012;Merz et al, 2015;Xu et al, 2018). The incidence of PN in 18 patients treated with PTD regimen in the after-2013 group was significantly decreased, thereinto, the incidence of grade 2 and higher was 22.2% (4/18), which was similar to a previous study in China (Wang et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

“…In 2006, bortezomib was approved for the treatment of MM patients in China, and has been adopted as the first-line treatment option for MM since February 2006 in our center (Zheng et al, 2009;He et al, 2014), with an ORR of up to 90%, very good PR (VGPR) or better greater than 60%. The main non-hematological adverse reactions were herpesvirus infection and peripheral neuropathy (PN), which significantly affected the clinical use of bortezomib and treatment durations (He et al, 2014;Xu et al, 2018). In addition, as bortezomib was expensive and not covered by the National Health Insurance in the early stage, most patients discontinued treatment after their disease being controlled.…”

mentioning

confidence: 99%

Bortezomib-Based Regimens for Newly Diagnosed Multiple Myeloma in China: A Report of 12-Year Real-World Data

Han

et al. 2020

Front. Pharmacol.

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Background: Improve the treatment quality might affect patients’ efficacy and survival.Methods: Five hundred thirty multiple myeloma patients treated in four hematological centers in China from February 2006 to August 2018 were enrolled. General characteristics, treatment regimens and cycles, efficacy, survival and adverse events of the patients treated before and after August 2013 (later refer to as the before-2013 and after-2013 group) were analyzed and compared.Results: The results suggested that patients who received optimized treatment regimen and route of administration completed more cycles of treatment in the after-2013 group. Although the overall response rate was similar between the two groups (88.6 vs. 90.5%), patients in the after-2013 group had higher complete remission rate (39.1 vs. 28.6%) and better progression-free survival. Subgroup analysis suggested that patients aged 65 years and older, with non-high-risk D-S, ISS, and R-ISS stages, had a significant benefit in progression-free survival.Conclusion: Therefore, in clinical practice in China, by reducing the economic burden brought by the treatment on patients and optimizing the treatment regimen, more patients can be treated with better regimens in a prolonged duration to achieve better efficacy and survival, especially in elderly and non-high-risk patients.

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“…On the other hand, Minarik et al [42] reported similar effectiveness but also similar adverse reactions of subcutaneous and intravenous bortezomib. In addition, Xu et al [43] highlighted that subcutaneous bortezomib is associated with better tolerability, intravenous bortezomib achieves faster and deeper response. Nevertheless, these results strongly suggest that subcutaneous and intravenous injections had similar effectiveness and prognosis in the treatment of MM patients.…”

Section: Discussionmentioning

confidence: 99%

Once-weekly bortezomib had similar effectiveness and lower thrombocytopenia occurrence compared with twice-weekly bortezomib regimen in treating patients with newly diagnosed multiple myeloma in China

Yao

Zhou

et al. 2019

Medicine

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The study aims to examine the treatment effect and adverse reactions of patients with newly diagnosed MM receiving different bortezomib-based regimens.This was a retrospective study of patients with newly diagnosed MM and who were treated with bortezomib-based combined chemotherapy at the Department of Hematology of the 2 affiliated hospitals of Wenzhou Medical University between July 2009 and May 2016. Cox proportion hazard multivariate analyses were carried out to assess the differences in treatment effect and adverse events between standard (1.3 mg/m2 on days 1, 4, 8, 11) and weekly (1.6 mg/m2 on days 1, 8, 15) cohorts, as well as the differences between intravenous injection and subcutaneous injection therapy. Progression-free survival (PFS) and overall survival (OS) were assessed using Kaplan–Meier method and the log-rank test.Among the 117 patients, 78 patients were treated with bortezomib standard therapy and 39 patients were treated with bortezomib weekly therapy (all with intravenous injection). In all patients, the treatment strategy was not independently associated with PFS or OS. The patients in the weekly therapy group had less thrombocytopenia events than those in the standard therapy group. The subcutaneous route had similar treatment effect as the intravenous route, but the incidence of peripheral neuropathy was lower.The once-weekly bortezomib regimen was similar in effectiveness to standard therapy in treating patients with newly diagnosed MM, but the incidence of thrombocytopenia was lower with the weekly regimen compared with the standard regimen.

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Tolerance, Kinetics, and Depth of Response for Subcutaneous Versus Intravenous Administration of Bortezomib Combination in Chinese Patients With Newly Diagnosed Multiple Myeloma

Abstract: SC Btz is associated with better tolerance; however, IV administration achieves a faster and deeper response in Chinese patients with newly-diagnosed multiple myeloma.

Cited by 8 publications

References 30 publications

<p>Analysis of the efficacy and safety of bortezomib for treating newly diagnosed multiple myeloma through different administration methods</p>

<p>Analysis of the efficacy and safety of bortezomib for treating newly diagnosed multiple myeloma through different administration methods</p>

Bortezomib-Based Regimens for Newly Diagnosed Multiple Myeloma in China: A Report of 12-Year Real-World Data

Once-weekly bortezomib had similar effectiveness and lower thrombocytopenia occurrence compared with twice-weekly bortezomib regimen in treating patients with newly diagnosed multiple myeloma in China

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