Elderly Myeloma Patients Benefit from Lower-Dose Drug Regimen, Addition of Velcade

A new study revealed that lower doses of Velcade (bortezomib), melphalan (Alkeran) and prednisone (VMP) was effective and safe in extending overall and progression-free survival in older patients.

A new study revealed that lower doses of Velcade (bortezomib), melphalan (Alkeran) and prednisone (VMP)—a common treatment regimen in Europe for patients with multiple myeloma (MM) who are ineligible for stem cell transplantation—was effective and safe in extending overall and progression-free survival in older patients. Using this regimen significantly increased event-free survival compared with using MP alone.

The study, published in the journal Cancer, sought to determine if older patients who do not respond to initial treatment or experience a relapse after their initial treatment would benefit from a lower dose formulation of VMP. They noted that in general, older patients have poorer overall health than most patients, and the severe side effects of VMP often cause them to discontinue treatment.

Researchers looked at 42 patients with relapsed or refractory multiple myeloma from March 2008 to February 2010. Participants received 2 mg of melphalan 3 times a week, 1.3 mg/m² of Velcade once a week, and 50 mg or prednisone every other day throughout a 28-day treatment cycle, of which there were 9 in total.

Fifty-seven percent of patients had at minimum a partial response to treatment, and the median time to progression was 18 months. The progression-free survival rate at 37 months was 21%, whereas the median overall survival rate was 30 months.

“A weekly infusion of bortezomib associated with lower dose-intensity MP induced a high proportion of responses and was well tolerated in elderly patients with relapsed/refractory MM,” the researchers concluded.