Transplant-eligible multiple myeloma: VRd lite delivers deep responses

  • Okazuka K & al.
  • Eur J Haematol
  • 16 Nov 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • In transplant-eligible patients with newly diagnosed multiple myeloma (NDMM), the intensity-reduced regimen VRd lite (reduced-intensity bortezomib+lenalidomide+dexamethasone) delivered deep responses, which grew deeper after transplantation; the regimen was also well tolerated.

Why this matters

  • VRd is one of the most common regimens in this setting; however, 9%-11% of patients discontinue VRd because of tolerability issues.

Study design

  • Study to investigate VRd lite in 48 transplant-eligible patients with NDMM.
  • VRd lite was administered every 4 weeks, comprising:
    • Bortezomib 1.3 mg/m2 on days 1, 8, 15, and 22.
    • Dexamethasone 20 mg on the day of and day after bortezomib.
    • Lenalidomide was omitted on days 1, 8, and 15.
  • Funding: None.

Key results

  • After 4 cycles:
    • 83% overall response rate (ORR).
    • 25% complete response (CR).
    • 48% very good partial response or better (≥VGPR).
  • 38/45 patients who completed 4 cycles of VRd went on to receive autologous stem cell transplant (auto-SCT).
  • Responses were improved posttransplant:
    • 100% ORR.
    • 55% CR.
    • 73.7% ≥VGPR.
  • The most common grade 3-4 adverse event was neutropenia (grade 3, 19%; grade 4, 6%).

Limitations

  • Retrospective data.