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.
多发性骨髓瘤（MM）的诱导治疗方案通常包含硼替佐米，尽管研究已表明每周一次给药方案具有相当的疗效且外周神经病变（PN）发生率更低，但传统上多采用每周两次给药。本研究旨在分析新诊断MM患者中每周一次与每周两次硼替佐米方案在真实世界中的使用普遍性及疗效。我们基于全国性Flatiron Health电子健康记录衍生数据，分析了2497名18-70岁接受商业一线硼替佐米治疗的美国患者，其中910名（36.4%）接受每周两次方案，1522名（63.2%）接受每周一次方案。每周一次硼替佐米的使用率随时间逐步上升，从2017年的57.7%增至2022年的73.1%。多变量分析显示，体能状态较差及诊断年份较近与接受每周一次硼替佐米的几率较高相关。真实世界无进展生存期（每周一次方案中位37.2个月对比每周两次方案中位39.6个月，p=0.906）与总生存期（两组中位生存期均未达到，p=0.800）结果相当。每周两次方案患者的PN发生率更高（34.7%对比18.5%，p<0.001）。综上所述，与每周两次方案相比，每周一次硼替佐米方案明确具有相似疗效且毒性更低。我们的研究结果支持每周一次硼替佐米方案作为新诊断MM患者的标准治疗方案。
肿瘤(癌症)患者之家