OBJECTIVES: This study compared the use of bortezomib in different combination regimens in newly diagnosed multiple myeloma (NDMM) patients who were transplant ineligible. PATIENTS AND METHODS: We analyzed data from the Registry of Monoclonal Gammopathies (RMG) of the Czech Myeloma Group (CMG) to provide real-world evidence of outcome for 794 newly diagnosed MM transplant ineligible patients. The most frequently used regimen was VCd (bortezomib-cyclophosphamide-dexamethasone) (47.5%) over VMP (bortezomib-melphalan-prednisone) (21.7%), BDd (bortezomib-doxorubicin-dexamethasone) (9.8%), and VTd (bortezomib-thalidomide-dexamethasone) (2.9%). RESULTS: The overall response rate (ORR) was 69.2% (478/691), including 12.6% (≥ CR); 34.7% very good partial responses (VGPR); and 21.9% partial responses (PR). Among triplet regimens, VMP was the most effective regimen compared to VCd, BDd, and VTd. Median PFS was 22.3 vs. 18.5 vs. 13.7 vs. 13.8 mo, (P = .275), respectively, and median OS was 49 vs. 41.7 vs. 37.9 vs. 32.2 mo (P = .004), respectively. The most common grade 3-4 toxicities were anemia in 17.4% and infections in 18% of patients. CONCLUSION: Our study confirmed that bortezomib-based treatment is effective and safe in NDMM transplant ineligible patients, especially VMP, which was identified as superior between bortezomib-based induction regimens not only in clinical trials, but also in real clinical practice.

1st Department of Medicine Department of Hematology Charles University and General Hospital Prague Czech Republic

4th Department of Internal Medicine Hematology University Hospital and Charles University in Hradec Kralove Hradec Kralove Czech Republic

Babak Myeloma Group Department of Pathophysiology Masaryk University Brno Czech Republic

Department of Clinical Hematology Hospital Ceske Budejovice Ceske Budejovice Czech Republic

Department of Clinical Hematology Hospital Havirov Czech Republic

Department of Clinical Hematology Hospital Liberec Czech Republic

Department of Clinical Hematology Hospital Novy Jicin Czech Republic

Department of Clinical Hematology Regional Health Corporation Masaryk Hospital Usti nad Labem Czech Republic

Department of Hemato Oncology University Hospital Olomouc Olomouc Czech Republic

Department of Hematology and Transfusion Medicine Hospital Pelhrimov Czech Republic

Department of Hematology Silesian Hospital in Opava Opava Czech Republic

Department of Hematooncology University Hospital Ostrava University of Ostrava Ostrava Czech Republic

Department of Internal Medicine and Hematology Charles University and Faculty Hospital Kralovske Vinohrady Prague Czech Republic

Department of Internal Medicine Hematology and Oncology University Hospital Brno Czech Republic

Hematology and Oncology Department Charles University Hospital Pilsen Pilsen Czech Republic

Institute of Biostatistics and Analyses Masaryk University Brno Czech Republic

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