Is re-challenge still an option as salvage therapy in multiple myeloma? The case of REal-life BOrtezomib re-Use as secoND treatment for relapsed patients exposed frontline to bortezomib-based therapies (the REBOUND Study)

• Published in: Annals of hematology 2019-02, Vol.98 (2), p.361-367
• Main Authors: Musto, Pellegrino, Simeon, Vittorio, Cascavilla, Nicola, Falcone, Antonietta, Petrucci, Maria Teresa, Cesini, Laura, Di Raimondo, Francesco, Conticello, Concetta, Ria, Roberto, Catalano, Lucio, Salvatore, Dalila, Mastrullo, Lucia, Gagliardi, Alfredo, Villani, Oreste, Pietrantuono, Giuseppe, D’Arena, Giovanni, Mansueto, Giovanna, Bringhen, Sara, Genuardi, Mariella, Di Renzo, Nicola, Reddiconto, Giovanni, Fragasso, Alberto, Caravita, Tommaso, Scapicchio, Daniele, Marziano, Gioacchino, Boccadoro, Mario, Mangiacavalli, Silvia, Corso, Alessandro
• Format: Article
• Language: English
• Subjects: Hematology; Inhibitor drugs; Medicine; Medicine & Public Health; Multiple myeloma; Oncology; Original Article; Targeted cancer therapy
• ISSN: 0939-5555; 1432-0584
• DOI: 10.1007/s00277-018-3524-1

Therapeutic re-challenge is currently a debated issue in the field of multiple myeloma (MM), given the recent availability of several new drugs and combinations. However, very few specific evidences are available about bortezomib re-use at first relapse. This multicenter, observational, retrospective study enrolled 134 MM patients with significant response after bortezomib-based frontline regimens and who had received a first salvage treatment containing bortezomib at relapse. The overall response rate was 71%, including 40% partial responses, 24% very good partial responses, and 7% complete responses. Re-treatment was well-tolerated, with no significant new or unexpected toxicities observed. The median duration of second progression-free survival (PFS) was 15 months, while median PFS2 was 55 months. With a median follow-up of 56 months, overall survival was 94 months for the entire series, without significant differences between patients undergoing or not undergoing transplant procedures. This real-life survey indicates that re-treatment including bortezomib as a first salvage therapy could be still considered in MM patients achieving durable response after initial exposure to bortezomib.