Multiple Myeloma Coverage from Every Angle

Bortezomib- Versus Lenalidomide-Based Treatments in Multiple Myeloma

By: Kayci Reyer
Posted: Tuesday, April 14, 2020

According to a phase III randomized trial published in the British Journal of Haematology, a regimen of bortezomib/cyclophosphamide/dexamethasone (VCD) and a regimen of lenalidomide/cyclophosphamide/dexamethasone (RCD) resulted in comparable survival outcomes in patients with multiple myeloma at first relapse. The study sought to determine whether either treatment was superior in a head-to-head comparison.

“Bortezomib and lenalidomide treatments were equally effective in terms of depth of response, [progression-free survival], and [overall survival] in [patients with multiple myeloma] at first relapse,” concluded Vittorio Montefusco, MD, of the Fondazione IRCCS Istituto Nazionale dei Tumori in Italy, and colleagues. “The choice of treatment should therefore be based on patients’ characteristics and preferences, residual toxicities, and drug class sequencing.”

Between March 2011 and February 2015, the study enrolled 155 patients with multiple myeloma who were experiencing their first relapse. Participants were randomly assigned to receive nine cycles of either VCD or RCD. At 6 weeks post-treatment, 12 patients (15%) in the bortezomib group versus 14 patients (18%) in the lenalidomide group had achieved at least a very good partial response (P = .70).

Both groups also experienced similar survival benefits. The median progression-free survival and 2-year overall survival were 16.3 months and 75%, respectively, with bortezomib versus 18.6 months and 74% with lenalidomide. Neither patients with previous exposure to bortezomib nor patients who were naive to either bortezomib or lenalidomide experienced a notable difference in progression-free survival. Tolerance of both medications was in line with expectations based on their established safety profiles.

Disclosure: For full disclosures of the study authors, visit

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