The following article features coverage from the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting. Click here to read more of Hematology Advisor‘s conference coverage.

Among patients with newly diagnosed multiple myeloma (MM), adding pegylated liposomal doxorubicin (PLD) to a bortezomib-based chemotherapy regimen does not appear to improve overall survival (OS) outcomes, according to research published in Frontiers in Oncology.

MM, which is characterized by abnormal bone marrow cell proliferation and bone damage, is most frequently treated using a chemotherapy regimen. Although many first-line chemotherapy regimens rely on doxorubicin, the adverse events (AEs) resulting from treatment can be severe, and some patients may not be able to tolerate toxic therapy.

PLD, a liposomal form of doxorubicin, is associated with a longer circulation time and improved tumor uptake. While previous research has shown that PLD may yield improved outcomes when used with bortezomib-based chemotherapy among patients with relapsed/refractory MM, the clinical effects of this combined regimen in the newly diagnosed setting have not previously been investigated.


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For this study, researchers evaluated the safety and efficacy of PLD, in combination with vindesine-based and bortezomib-based chemotherapy regimens, among newly diagnosed patients with MM.

Of the 249 patients enrolled, 112 were assigned to receive a vindesine-based regimen (35 to PLD, vindesine, and dexamethasone [vDD] and 77 to epirubicin, vindesine, and dexamethasone [vAD]), and 137 were assigned to receive a bortezomib-based regimen (58 to PLD, bortezomib, and dexamethasone [VDD] and 79 to bortezomib and dexamethasone [VD]).

Among patients who received a bortezomib-based regimen, the median follow-up period was 16 months. More patients in the VDD group had a complete response (48.3% vs 30.4% in the VD group; P =.033) and a very good partial response or better (74.1% vs 57% in the VD group; P =.038).

The median progression free survival (PFS) and OS periods were not different between the 2 groups (P =.875 and P =.448, respectively).

The median follow-up period in the vindesine groups was 25 months. The overall response rates in the vDD and vAD groups were 65.7% and 63.6%, respectively, which the authors wrote were not significantly different. PFS and OS did not, similarly, differ between the vDD and vAD groups (P =.135 and P =.240, respectively).

Grade 3 or 4 hematologic AEs were more common in the VDD than in the VD group (39.7% vs 17.7%, respectively; P =.004), though not overall in vDD vs vAD (P =.126). Infections were, however, more common with VDD (51.4%) than with vAD (24.7%; P =.005).

“The vDD regimen was similar with vAD in the aspect of response rate, survival, and toxicity in NDMM patients,” the authors wrote. “The addition of PLD to VD brought deeper response without increased toxicity, while no superior survival was found.”

Read more of Hematology Advisor’s coverage of the 2021 ASCO Annual Meeting by visiting the conference page.

Reference

Zhai Y, Yuan D, Ge X, et al. Pegylated liposomal doxorubicin in vindesine-based and bortezomib-based regimens for patients with newly diagnosed multiple myeloma: a retrospective study of efficacy and safety. Front Oncol. 2021;11:597453. doi:10.3389/fonc.2021.597453