Bortezomib plus Melphalan and Prednisone for Initial Treatment of Multiple Myeloma

Patients with newly diagnosed multiple myeloma who were ineligible for treatment with high-dose chemotherapy plus hematopoietic stem-cell transplantation were randomly assigned to receive either melphalan and prednisone alone or melphalan and prednisone plus bortezomib. The time to disease progression (the primary outcome) was longer in the bortezomib group. The combination of bortezomib, melphalan, and prednisone appears to be effective as initial treatment in patients with multiple myeloma who cannot withstand high-dose therapy. The combination of bortezomib, melphalan, and prednisone appears to be effective as initial treatment in patients with multiple myeloma who cannot withstand high-dose therapy. Therapy with melphalan plus prednisone, which has been the standard of care for patients with newly diagnosed multiple myeloma for more than 40 years, 1 , 2 is associated with a median survival of 29 to 37 months. 3 – 6 During the past decade, high-dose therapy with hematopoietic stem-cell transplantation has become the preferred treatment for patients under the age of 65 years, 7 – 9 but older patients and patients with clinically significant coexisting illnesses usually do not tolerate this treatment. Since the median age at diagnosis of myeloma is approximately 70 years, 10 more than half the patients with newly diagnosed myeloma may not . . .