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International Journal of Hematology

, Volume 108, Issue 1, pp 39–46 | Cite as

Bortezomib maintenance therapy in transplant-ineligible myeloma patients who plateaued after bortezomib-based induction therapy: a multicenter phase II clinical trial

  • Atsushi Isoda
  • Kayoko Murayama
  • Shigeki Ito
  • Yoichi Kohara
  • Masaki Iino
  • Yuri Miyazawa
  • Morio Matsumoto
  • Hiroshi Handa
  • Yosuke Imai
  • Takuro Ishiguro
  • Wataru Izumita
  • Kiyoshi Kitano
  • Yukio Hirabayashi
  • Hideyuki Nakazawa
  • Fumihiro Ishida
  • Toru Mitsumori
  • Keita Kirito
  • Takaaki Chou
  • Hirokazu Murakami
  • For the Kanshinetsu Multiple Myeloma Study Group
Original Article

Abstract

In the era of novel therapeutic agents for multiple myeloma (MM), both the significance of achieving the plateau phase and the efficacy of subsequent maintenance therapy remain unclear. In the present study, we evaluated the efficacy and safety of bortezomib maintenance therapy (biweekly for 1 year) in transplant-ineligible MM patients who plateaued after bortezomib-based induction therapy. Of 36 evaluable patients, the overall response rate during induction therapy was 61%, with a stringent complete response in 6%, a complete response in 6%, a very good partial response in 17%, and a partial response in 33%. Twenty patients achieved the plateau phase and subsequently received bortezomib maintenance therapy. Median progression-free survival from the induction and maintenance therapies was 13.8 months (95% confidence interval, 11.4–23.7 months) and 10.7 months (95% confidence interval, 3.7–10.7 months), respectively. During maintenance therapy, there were no cases with grade ≥ 2 peripheral neuropathy, nor was there any improvement in the quality of the response. In conclusion, although maintenance therapy with biweekly bortezomib for up to 1 year was feasible, plateau-oriented bortezomib induction therapy followed by bortezomib maintenance therapy was not adequate in newly diagnosed transplant-ineligible MM patients.

Keywords

Multiple myeloma Bortezomib Plateau phase Maintenance Transplant-ineligible 

Notes

Acknowledgements

We thank all of the patients who participated in this study and their families as well as all investigators, physicians, nurses, and clinical research coordinators who helped with this study.

Compliance with ethical standards

Conflict of interest

K. Kirito received an honorarium from Novartis Pharma K.K. T. Chou received an honorarium from Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Celgene K.K., Bristol-Myers Squibb, Janssen Pharmaceutical K.K., and Novartis Pharma K.K. H. Murakami received an honorarium from Ono Pharmaceutical Co. Ltd. and Bristol-Myers Squibb.

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Copyright information

© The Japanese Society of Hematology 2018

Authors and Affiliations

  • Atsushi Isoda
    • 1
  • Kayoko Murayama
    • 2
  • Shigeki Ito
    • 3
  • Yoichi Kohara
    • 4
  • Masaki Iino
    • 5
  • Yuri Miyazawa
    • 1
  • Morio Matsumoto
    • 1
  • Hiroshi Handa
    • 6
  • Yosuke Imai
    • 7
  • Takuro Ishiguro
    • 7
  • Wataru Izumita
    • 8
  • Kiyoshi Kitano
    • 9
  • Yukio Hirabayashi
    • 9
  • Hideyuki Nakazawa
    • 10
  • Fumihiro Ishida
    • 11
  • Toru Mitsumori
    • 12
  • Keita Kirito
    • 12
  • Takaaki Chou
    • 7
  • Hirokazu Murakami
    • 13
  • For the Kanshinetsu Multiple Myeloma Study Group
  1. 1.Department of HematologyNational Hospital Organization Shibukawa Medical CenterShibukawaJapan
  2. 2.Department of HematologyGunma Cancer CenterGunmaJapan
  3. 3.Department of Medical OncologyIwate Medical University School of MedicineIwateJapan
  4. 4.Department of HematologyShowa Inan General HospitalNaganoJapan
  5. 5.Department of Medical OncologyYamanashi Prefectural Central HospitalYamanashiJapan
  6. 6.Department of Medicine and Clinical ScienceGunma University Graduate School of MedicineGunmaJapan
  7. 7.Department of Internal MedicineNiigata Cancer Center HospitalNiigataJapan
  8. 8.Department of HematologyIwate Prefecture Ofunato HospitalIwateJapan
  9. 9.Department of HematologyNational Hospital Organization Matsumoto Medical CenterNaganoJapan
  10. 10.Division of Hematology, Department of Internal MedicineShinshu University School of MedicineNaganoJapan
  11. 11.Department of Biomedical Laboratory MedicineShinshu University School of MedicineNaganoJapan
  12. 12.Division of Hematology and OncologyUniversity of YamanashiYamanashiJapan
  13. 13.Department of Laboratory SciencesGunma University Graduate School of Health SciencesGunmaJapan

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