Bortezomib (Velcade) in combination with dexamethasone for relapsed or refractory myeloma
The proteasome inhibitor bortezomib (Velcade) has demonstrated clinical activity in patients with multiple myeloma (MM). We report the activity of bortezomib plus dexamethasone in 60 patients with relapsed and refractory myeloma. The patients had a median age of 65 years (range, 38-79 years). The median number of previous treatments was 3 (range, 1-9). For patients who received bortezomib plus dexamethasone the overall response rate was 73%. 38% patients achieved CR. CR in patients receiving bortezomib plus dexamethasone earlier vs later (≤ 3 и ≥ 4 line chemotherapy) were: 48% vs 27,5%. Bortezomib is active in patients with relapsed MM, including elderly patients. Side effects were predictable and manageable; principal toxicities were hematological, gastrointestinal, and peripheral neuropathy. The most common adverse events reported were asthenia (52%), neuropathy (53%), thrombocytopenia (32%), anemia (30%). Neuropathy greater than grade 2 was more frequent in patients who received 3 or more prior therapy regimens.