VCd versus VRd in newly diagnosed multiple myeloma: matched real-world analysis from the Balkan myeloma study group (BMSG)

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dc.authorscopusidMeral Beksac / 56924887200
dc.authorwosidMeral Beksac / D-6411-2013
dc.contributor.authorKastritis, Efstathios
dc.contributor.authorBeksac, Meral
dc.contributor.authorBadelita, Sorina Nicoleta
dc.contributor.authorKatodritou, Eirini
dc.contributor.authorBila, Jelena
dc.contributor.authorSpanoudakis, Emmanouil
dc.date.accessioned2025-04-17T12:36:27Z
dc.date.available2025-04-17T12:36:27Z
dc.date.issued2025
dc.departmentİstinye Üniversitesi, Tıp Fakültesi, İSÜ Hastaneleri
dc.description.abstractAs induction therapy, VRd demonstrated superior efficacy in terms of response rates over VCd, but not in PFS and OS in the real-world setting. Long-term outcomes are driven by effective consolidation and use of maintenance. VCd induction remains a reasonable option for patients for which VRd may not be feasible or well-tolerated and could find a niche in novel combinations. Background: Bortezomib, dexamethasone and cyclophosphamide (VCd) remains a popular regimen, due to its activity and low toxicity, while bortezomib, lenalidomide and dexamethasone (VRd) is widely used in US and Europe; both are combined with anti-CD38 monoclonal antibodies but VCd and VRd have not been compared directly in adequately powered prospective trials. Aim: We compared the outcomes of 1216 patients treated with VCd ( N = 690) or VRd ( N = 526) in a real-world setting. Results: Patients treated with VCd had more often severe renal dysfunction, ISS3 disease, hypercalcemia, elevated LDH, anemia, thrombocytopenia, poor performance while VRd-treated were older and received less often autologous transplant but more frequently maintenance but the duration of induction was similar. VRd was associated with substantially higher overall response and CR/VGPR rates to induction( P < .001) and improved PFS and OS in univariate analysis, especially among patients with standard risk disease, without renal dysfunction and in the elderly; however, in multivariate analysis there was no significant difference in either PFS or OS. In patients strictly matched 1:1 for major prognostic variables (188 in each group, total N = 376), the super ior ity of VRd in terms of responses rates and depth of response was confirmed, but without significant PFS or OS difference. Conclusion: VRd is a more active induction regimen than VCd, although use of maintenance with lenalidomide may dilute the PFS or OS benefit. VCd induction remains an option in special circumstances. With the implementation of monoclonal antibodies, VCd backbone can be considered for patients without access to or who do not tolerate VRd.
dc.identifier.citationKastritis, E., Beksac, M., Badelita, S. N., Katodritou, E., Bila, J., Spanoudakis, E., ... & Balkan Myeloma Study Group. (2025). VCd versus VRd in Newly Diagnosed Multiple Myeloma: Matched Real-World Analysis from the Balkan Myeloma Study Group (BMSG). Clinical Lymphoma Myeloma and Leukemia, 25(2), e71-e81.
dc.identifier.doi10.1016/j.clml.2024.08.007
dc.identifier.endpage81
dc.identifier.issn2152-2650
dc.identifier.issn2152-2669
dc.identifier.issue2
dc.identifier.pmid39304364
dc.identifier.scopus2-s2.0-85204450749
dc.identifier.scopusqualityQ3
dc.identifier.startpage71
dc.identifier.urihttp://dx.doi.org/10.1016/j.clml.2024.08.007
dc.identifier.urihttps://hdl.handle.net/20.500.12713/6249
dc.identifier.volume25
dc.identifier.wosWOS:001418033400001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.institutionauthorBeksac, Meral
dc.institutionauthoridMeral Beksac / 0000-0003-1797-8657
dc.language.isoen
dc.publisherElsevier inc.
dc.relation.ispartofClinical lymphoma, myeloma and leukemia
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectBortezomib
dc.subjectHigh-Risk Myeloma
dc.subjectInduction Therapy
dc.subjectLenalidomide
dc.subjectPrognosis
dc.subjectResistance
dc.titleVCd versus VRd in newly diagnosed multiple myeloma: matched real-world analysis from the Balkan myeloma study group (BMSG)
dc.typeArticle

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