Blood Cancer Journal (Mar 2024)

Once-weekly versus twice-weekly bortezomib in newly diagnosed multiple myeloma: a real-world analysis

  • Fieke W. Hoff,
  • Rahul Banerjee,
  • Adeel M. Khan,
  • Georgia McCaughan,
  • Bo Wang,
  • Xiaoliang Wang,
  • James Roose,
  • Larry D. Anderson,
  • Andrew J. Cowan,
  • S. Vincent Rajkumar,
  • Gurbakhash Kaur

DOI
https://doi.org/10.1038/s41408-024-01034-6
Journal volume & issue
Vol. 14, no. 1
pp. 1 – 8

Abstract

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Abstract Induction regimens for multiple myeloma (MM) commonly include bortezomib, which has typically been administered twice weekly despite studies demonstrating comparable efficacy and less peripheral neuropathy (PN) with once-weekly bortezomib. We aimed to analyze the real-world prevalence and efficacy of once-weekly versus twice-weekly bortezomib regimens in newly diagnosed MM. We analyzed 2497 US patients aged 18–70 years treated with commercial first-line bortezomib using nationwide Flatiron Health electronic health record-derived data, including 910 (36.4%) patients who received twice-weekly and 1522 (63.2%) who received once-weekly bortezomib. Once-weekly bortezomib use increased over time, from 57.7% in 2017 to 73.1% in 2022. Multivariate analysis identified worsened performance status and more recent year of diagnosis with higher odds of receiving once-weekly bortezomib. Real-world progression-free survival (median 37.2 months with once-weekly versus 39.6 months with twice-weekly, p = 0.906) and overall survival (medians not reached in either cohort, p = 0.800) were comparable. PN rates were higher in patients receiving twice-weekly bortezomib (34.7% versus 18.5%, p < 0.001). In conclusion, once-weekly bortezomib is clearly associated with similar efficacy and fewer toxicities compared to twice-weekly bortezomib. Our findings support once-weekly bortezomib as a standard-of-care regimen for newly diagnosed patients with MM.