What is the efficacy of combination therapy with bortezomib for the treatment of multiple myeloma (MM)?

Updated: May 11, 2021
  • Author: Dhaval Shah, MD; Chief Editor: Emmanuel C Besa, MD  more...
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The phase III Velcade as Initial Standard Therapy in MM (VISTA) trial found that the combined treatment of bortezomib, melphalan, and prednisone (VMP) significantly prolongs overall survival compared with melphalan and prednisone (MP) after lengthy follow-up and extensive subsequent antimyeloma therapy. A notable outcome of this study was that first-line bortezomib use did not induce more resistant relapse. VMP used upfront appears more beneficial than first treating with conventional agents and saving bortezomib-based and other novel-agent–based treatment until relapse. [60]

A study by Harousseau et al confirms the role of bortezomib in the initial nonintensive management of MM. [61]

A study by Sher et al found that a combination of bortezomib, pegylated liposomal doxorubicin, and thalidomide, known as the VDT regimen, had overall response rate and complete plus near-complete response rates of 78% and 35%, respectively. [60] The study concluded that VDT was a tolerable and effective regimen that may induce high response rates in patients considered to be poor candidates for steroid-based treatments.

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