FACULTY COMMENTS
DR ORLOWSKI: Data from the early Phase II studies suggested
that patients with deletion 13 did well with bortezomib, which was
later borne out in the APEX trial. This paper provided further follow-up
and also examined other poor-risk features, such as a 4;14
translocation. The findings suggest that in patients with relapsed
multiple myeloma, incorporation of bortezomib is important and
improves outcomes in patients with these poor-risk features.
In Cavo’s trial, comparing VTD versus TD, and Harousseau’s VD versus VAD studies, patients with deletion in chromosome 13 did well with the bortezomib combinations. In the Italian study, VTD induced a better complete and near-complete response rate in cases of deletion 13 or a 4;14 translocation. However, we still don’t know how durable the responses are. The problem with these patients has not necessarily been that their disease didn’t respond, but that it didn’t stay in a good response category, so we need long-term follow-up.
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