Once-weekly bortezomib as the standard of care in multiple myeloma: results from an international survey of physicians
Rahul Banerjee, Bo Wang, Larry D. Anderson, Georgia McCaughan, Nikita Mehra, Andrew J. Cowan, S. Vincent Rajkumar, Gurbakhash Kaur
Abstract
The proteasome inhibitor bortezomib is a key component of treatment regimens for newly diagnosed multiple myeloma (MM). Bortezomib has been dosed twice per week in both industry-sponsored and consortium-run trials of MM induction regimens [ 1 , 2 , 3 , 4 , 5 ]. However, several analyses (Table 1 ) have demonstrated comparable efficacy with once-weekly versus twice-weekly bortezomib in MM [ 6 , 7 , 8 , 9 ]. Once-weekly bortezomib has also been associated with lower rates of peripheral neuropathy (PN), with a matched adjusted indirect comparison (MAIC) analysis of randomized controlled trial (RCT) data demonstrating any-grade PN incidences of 32% with once-weekly versus 47% with twice-weekly dosing [ 7 ]. MM trial protocols often continue to use twice-weekly bortezomib based under the assumption that dosing schedules from previous trials constitute the standard of care (SOC) for newly diagnosed MM. In contrast, a more accurate definition of SOC regimens involves how typical physicians in the field would approach a given situation [ 10 , 11 ]. As such, we sought to survey physicians globally to understand their attitudes and perceptions regarding how bortezomib should be dosed. Table 1 Published studies of once-weekly versus twice-weekly bortezomib. Full size table