Treatment Patterns and Outcomes in Over 2200 Newly Diagnosed Multiple Myeloma Patients: Supporting Bortezomib-Lenalidomide-Dexamethasone as a Preferred Regimen in the Absence of Anti-CD38 Antibodies.

BACKGROUND

Multiple myeloma (MM) is a hematologic malignancy defined by clonal proliferation of plasma cells in the bone marrow. The introduction of bortezomib, a proteasome inhibitor, has significantly improved outcomes in MM, becoming a cornerstone of therapy since its approvals for relapsed/refractory MM in 2003 and newly diagnosed MM (NDMM) in 2008. Bortezomib induces apoptosis in malignant plasma cells by disrupting protein degradation pathways.

RATIONALE: Triplet regimens combining bortezomib with immunomodulatory drugs, alkylating agents, and corticosteroids have shown high efficacy, especially in NDMM patients ineligible for autologous stem cell transplant (ASCT). However, clinical trials often underrepresent real-world populations, with 40% to 50% of MM patients not meeting eligibility criteria.

METHODS

To address this evidence gap, we performed a retrospective analysis of national real-world data from the Czech Republic, assessing 17 years of experience with bortezomib-based triplet regimens in transplant-ineligible NDMM patients.

CONCLUSIONS

This study provides critical insights into the long-term effectiveness and applicability of bortezomib-based therapies outside of controlled trial settings, offering a more comprehensive understanding of treatment outcomes in routine clinical practice.