BACKGROUND: Bortezomib, Melphalan and Prednisone (VMP) is now considered standard of care for the treatment of newly diagnosed multiple myeloma (NDMM) patients who are ineligible for autologous stem cell transplantation in Sweden. Several clinical studies have shown that a less intensive treatment schedule of bortezomib as part of a VMP regimen (modified VMP) is associated with similar survival outcomes to the schedule in label (VISTA VMP) and minimized toxicity.

OBJECTIVES: To understand the proportion of newly diagnosed transplant ineligible MM patients in clinical practice that received modified VMP vs VISTA VMP, and to describe time to next treatment (TTNT) and overall survival (OS) in this patient population.

METHODS: In the Stockholm and Gotland region, all NDMM patients with a MM diagnosis (n=1053) between 2005-2013 were identified in the national Cancer Registry. By unique identification numbers, patient level data was linked to the Patient Registry, the Cause of Death Registry and a regional medication database including all administered drugs. All individuals ineligible for transplantation who received VMP as first line treatment (n=47) were included in this cohort study and followed until 2015. OS and TTNT were calculated using the Kaplan–Meier method.

RESULTS: Median duration of treatment with VMP was 3.033 months (1.93-6.13) and median number of weekly bortezomib administrations was 1. All patients were therefore classified as receiving modified VMP treatment. Median OS was 45.1 months and median TTNT was 20.4 months. Two patients (4.2%) developed polyneuropathies during or after receiving VMP treatment.

CONCLUSIONS: Results from this regional cohort showed that all patients received a less intensive schedule than the approved VMP schedule. This was associated with low incidence of peripheral neuropathy (4.2%). OS was slightly shorter than what has previously been reported in clinical trials, potentially due to younger patients and longer treatment duration in clinical trials vs real world.