Effects of two bortezomib-based protocols (VCD and VRD) on responses and survival as induction treatment of patients with multiple myeloma eligible for autologous stem cell transplantation

Effects of Two Bortezomib-Based Protocols (VCD and VRD) on Responses and Survival as Induction Treatment of Patients with Multiple Myeloma Eligible for Autologous Stem Cell Transplantation Aim: This study was conducted to compare the VRD and VCD induction regimens in terms of response, survival, and side effects in multiple myeloma(MM) patients eligible for autologous stem cell transplantation(ASCT). Material and Method: Data from 133 MM patients eligible for ASCT were examined retrospectively. Information on demographics, laboratory results, imaging, pathology, response, survival, and side effects was collected. Results: Of the 133 patients, 73 received VCD, 20 received VRD and 40 patients had been treated with VRD regimen following VCD. Interim and end-of-treatment response rates of PR and above were higher in the VRD group. In the survival analysis, overall survival was significantly better with VRD while no significant difference in progression free survival was detected. In multivariate analysis, taking into account high cytogenetic risk, maintenance treatment and ISS, no significant survival difference was observed between induction treatment groups. There was no difference in terms of side effects. R2-ISS differentiated survival among patients better than ISS and R-ISS. Bortezomib once a week administration was associated with fewer neuropathy and didn't result in lower responses and survival. PET responses were independently associated with survival. Conclusions: VRD provided better responses and overall survival, but no significant difference was detected in multivariate analysis. Both regimens had similar side effect profiles. Weekly bortezomib use reduced neuropathy rate without affecting survival. Keywords: Autologous Stem Cell Transplantation, Multiple Myeloma, R2-ISS, VCD, VRD