Subcutaneous bortezomib in multiple myeloma patients induces similar therapeutic response rates as intravenous application but it does not reduce the incidence of peripheral neuropathy
Language English Country United States Media electronic-ecollection
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
25875484
PubMed Central
PMC4396992
DOI
10.1371/journal.pone.0123866
PII: PONE-D-14-48641
Knihovny.cz E-resources
- MeSH
- Bortezomib adverse effects therapeutic use MeSH
- Adult MeSH
- Incidence MeSH
- Remission Induction MeSH
- Injections, Intravenous MeSH
- Injections, Subcutaneous MeSH
- Middle Aged MeSH
- Humans MeSH
- Multiple Myeloma drug therapy MeSH
- Peripheral Nervous System Diseases epidemiology etiology MeSH
- Retrospective Studies MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Severity of Illness Index MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Bortezomib MeSH
OBJECTIVE: Subcutaneous (SC) application of bortezomib has been recently introduced as a new application route in multiple myeloma (MM) patients. We performed an analysis to compare the outcomes of bortezomib-based therapy in multiple myeloma (MM) patients treated using either intravenous (IV) or subcutaneous (SC) route of administration. PATIENTS AND METHODS: During January 2012 through December 2013, we performed a retrospective analysis of 446 patients with MM treated with bortezomib-based regimens (either once weekly - 63% or twice weekly - 27%) in both, the first line setting, and in relapse, with separate analysis of patients undergoing autologous stem cell transplantation. We assessed the response rates and toxicity profiles in both, IV and SC route of bortezomib administration. RESULTS: The response rates in both IV and SC arm were similar with overall response rate 71.7% vs 70.7%, complete remissions in 13.9% vs 8.6%, very good partial remissions in 30.8% vs 34.5% and partial remissions in 27% vs 27.6%. The most frequent grade ≥ 3 toxicities were anemia, thrombocytopenia and neutropenia, with no significant differences between IV and SC group. There were no significant differences in the rate of peripheral neuropathy (PN). PN of any grade was present in 48% in the IV arm and in 41% in the SC arm. PN grade ≥ 2 was present in 20% vs 18% and PN grade ≥ 3 was present in 6% vs 4%. CONCLUSIONS: We conclude that subcutaneous application of bortezomib has similar therapeutic outcomes and toxicity profile as intravenous route of application. In our cohort there was no difference in the incidence of PN, suggesting that PN is dose dependent and might be reduced by lower intensity schemes rather than by the route of administration.
Department of Clinical Hematology General Hospital Ceske Budejovice Czech Republic
Department of Clinical Hematology General Hospital Liberec Liberec Czech Republic
Department of Clinical Hematology University Hospital Hradec Kralove Czech Republic
Department of Clinical Hematology University Hospital Kralovske Vinohrady Praha Czech Republic
Department of Hematology and Transfusiology Silesian Hospital Opava Czech Republic
Department of Hematology and Transfusion Claudian Hospital Mlada Boleslav Czech Republic
Department of Hematology and Transfusion General Hospital Pelhrimov Czech Republic
Department of Internal Medicine Hematology and Oncology University Hospital Brno Brno Czech Republic
Department of Internal Medicine University Hospital Praha Czech Republic
Department of Oncology Hospital Novy Jicin Novy Jicin Czech Republic
Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic
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