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Clinical outcomes of bortezomib-based therapy in Taiwanese patients with multiple myeloma: A nationwide population-based study and a single-institute analysis


Autoři: Wei-Nung Liu aff001;  Chao-Feng Chang aff002;  Chi-Hsiang Chung aff003;  Wu-Chien Chien aff003;  Tzu-Chuan Huang aff001;  Yi-Ying Wu aff001;  Ching-Liang Ho aff001;  Jia-Hong Chen aff001
Působiště autorů: Division of Hematology/Oncology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff001;  Division of Gastroenterology, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff002;  School of Public Health, National Defense Medical Center, Taipei, Taiwan aff003;  Taiwanese Injury Prevention and Safety Promotion Association, National Defense Medical Center, Taipei, Taiwan aff004;  Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan aff005;  Graduate Institute of Clinical Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan aff006
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
prolekare.web.journal.doi_sk: https://doi.org/10.1371/journal.pone.0222522

Souhrn

Purpose

In a retrospective cohort study, we report the current epidemiology of patients with multiple myeloma (MM) and analyze the real-world clinical outcomes of bortezomib-based therapy.

Materials and methods

This retrospective study was mainly designed to evaluate the characteristics, treatment outcomes, and prognostic factors of patients with MM who received bortezomib-based therapy. We identified 5,726 patients in Taiwan with MM newly diagnosed between 2007 and 2015. Confidential data from the National Health Insurance Research Database (NHIRD) was used under strict guidelines, as it was made available in an electronic format for research purposes. In addition, we analyzed 96 patients who have been diagnosed with MM and were treated at the Tri-Service General Hospital (TSGH) between January 1, 2002, and December 31, 2018.

Results

Patients receiving first-line treatment with bortezomib had longer overall survival (OS) compared to those who received non-first-line treatment (p<0.001). In addition, the statistically lowest risk of mortality was when patients received first-line bortezomib followed by an autologous hematopoietic stem cell transplant (adjusted hazard ratio = 0.39, p<0.001). In the TSGH study, the patients were enrolled between January 1, 2002, and December 31, 2018, with an initial diagnosis of MM; there were 96 individuals treated with bortezomib. There was no statistically significant difference in the OS or progression-free survival (PFS) according to the gender, myeloma type, International Staging System stage, or treatment regimen. There was a significant difference in the PFS in patients receiving first-line bortezomib treatment with transplantation compared to those without transplantation (p = 0.021).

Conclusions

Bortezomib as a first-line treatment extended the OS in four-year mortality tracking and lowered the mortality risk according to the NHIRD analysis. In the TSGH analysis, the results indicated that the initial conditions of patients with MM have a lower influence on the OS and PFS after bortezomib-based therapy was administered.

Klíčová slova:

Research and analysis methods – Social sciences – People and places – Geographical locations – Medicine and health sciences – Health care – Health economics – Economics – Research design – Cohort studies – Pulmonology – Oncology – Cancers and neoplasms – Hematologic cancers and related disorders – Myelomas and lymphoproliferative diseases – Myelomas – Multiple myeloma – Hematology – Plasma cell disorders – Vascular medicine – Cardiology – Surgical and invasive medical procedures – Chronic obstructive pulmonary disease – Coronary heart disease – Asia – Health insurance – Transplantation – Taiwan – Blood and lymphatic system procedures – Bone marrow transplantation


Zdroje

1. Adams J and Kauffman M. Development of the proteasome inhibitor Velcade™(Bortezomib). Cancer Invest. 2004;22: 304–311. 15199612

2. Cartwright R, Gilman E, Gurney K. Time trends in incidence of hematological malignancies and related conditions. Br J Haematol. 1999;106: 281–295. doi: 10.1046/j.1365-2141.1999.01480.x 10460584

3. Chen JH, Chung CH, Wang YC, Hsu HN, Huang WY, Chien WC. Prevalence and mortality-related factors of multiple myeloma in Taiwan. PloS one. 2016;11: e0167227. doi: 10.1371/journal.pone.0167227 27907052

4. Chen YC, Wu JC, Chen TJ, Wetter T. A publicly available database accelerates academic production. BMJ. 2011;342: d637. doi: 10.1136/bmj.d637 21285219

5. Kumar SK, Rajkumar SV, Dispenzieri A, Lacy MQ, Hayman SR, Baudi FK, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111: 2516–2520. doi: 10.1182/blood-2007-10-116129 17975015

6. Kastritis E, Zervas K, Symeonidis A, Terpos E, Delimbassi S, Anagnastopoulos N, et al. Improved survival of patients with multiple myeloma after the introduction of novel agents and the applicability of the International Staging System (ISS): an analysis of the Greek Myeloma Study Group (GMSG). Leukemia. 2009;23: 1152. doi: 10.1038/leu.2008.402 19225533

7. Snowden JA, Ahmedzai SH, Ashcroft J, D’sa S, Littlewood T, Low E, et al. Guidelines for supportive care in multiple myeloma 2011. Br J Haematol. 2011;154: 76–103. doi: 10.1111/j.1365-2141.2011.08574.x 21517805

8. Huang SY, Yao M, Tang JL, Lee WC, Tsay W, Cheng AL, et al. Epidemiology of multiple myeloma in Taiwan: increasing incidence for the past 25 years and higher prevalence of extramedullary myeloma in patients younger than 55 years. Cancer, 2007;110: 896–905. doi: 10.1002/cncr.22850 17594697

9. National Health Insurance Research Database, Taiwan, (2015), http://nhird.nhri.org.tw/en/index.htm.

10. Kyle RA and Rajkumar SV. Multiple myeloma. N Engl J Med. 2004;351: 1860–1873. doi: 10.1056/NEJMra041875 15509819

11. Longitudinal Health Insurance Database (LHID), https://nhird.nhri.org.tw/en/Data_Subsets.html. 2010.

12. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, et al. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15: e538–e548. doi: 10.1016/S1470-2045(14)70442-5 25439696

13. Greipp P.R., et al., International staging system for multiple myeloma. 2005. 23(15): p. 3412–3420. doi: 10.1200/JCO.2005.04.242 15809451

14. Orlowski RZ and Kuhn DJ. Proteasome inhibitors in cancer therapy: lessons from the first decade. Clin Cancer Res. 2008;14: 1649–1657. doi: 10.1158/1078-0432.CCR-07-2218 18347166

15. Kane RC, Farrell AT, Sridhara R, Pazdur R. United States Food and Drug Administration approval summary: bortezomib for the treatment of progressive multiple myeloma after one prior therapy. Clin Cancer Res. 2006;12: 2955–2960. doi: 10.1158/1078-0432.CCR-06-0170 16707588

16. Bross PF, Kane R, Farrell AT, Abraham S, Benson K, Brower ME, et al. Approval summary for bortezomib for injection in the treatment of multiple myeloma. Clin Cancer Res. 2004;10: 3954–3964. doi: 10.1158/1078-0432.CCR-03-0781 15217925

17. Tang CH, Liu HY, Hou HA, Qiu H, Huang KC, Siggins S, et al. Epidemiology of multiple myeloma in Taiwan, a population based study. Cancer Epidemiol. 2018;55: 136–141. doi: 10.1016/j.canep.2018.06.003 29957398

18. Lin CK and Sung YC. Newly diagnosed multiple myeloma in Taiwan: the evolution of therapy, stem cell transplantation and new treatment agents. Hematol Oncol Stem Cell Ther. 2009;2: 385–393. 20139051

19. Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. N Engl J Med. 1996;335: 91–97. doi: 10.1056/NEJM199607113350204 8649495

20. Richardson PG, Barlogie B, Berenson J, Singhal S, Jagannath S, Irwin D, et al. A phase 2 study of bortezomib in relapsed, refractory myeloma. N Engl J Med. 2003;348: 2609–2617. doi: 10.1056/NEJMoa030288 12826635

21. Richardson PG, Sonneveid P, Schuster MW, Irwin D, Stadtmauer EA, Facon T, et al. Bortezomib or high-dose dexamethasone for relapsed multiple myeloma. N Engl J Med. 2005;352: 2487–2498. doi: 10.1056/NEJMoa043445 15958804

22. San Miguel JF, Schlag R, Khuageva NK, Dimopoulos MA, Shpilberg O, et al. Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma. N Engl J Med. 2008;359: 906–917. doi: 10.1056/NEJMoa0801479 18753647


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