Weekly bortezomib, pegylated liposomal Doxorubicin and dexamethasone is a safe and effective therapy fpr elderly patients with relapsed/refractory multiple myeloma

Background: The synergic, additive effect of bortezomib and pegylated liposomal doxorubicin (PLD) has never been tested in an elderly group of patients with relapsed/refractory multiple myeloma (MM). Patients and Methods: In this study, 25 patients with a median age of 75 years were treated with bortezomib at usual doses of 1.3 mg/m2 every 21 days. After 2 cycles, bortezomib was given intravenously (I.V.) weekly every 32 days. Pegylated liposomal doxorubicin 30 mg/m2 I.V. was given on day 4 for 2 cycles and then was given on day 8. Dexamethasone 40 mg I.V. was given on days 1-4 for 2 cycles and then 20 mg weekly. Results: Bortezomib/PLD/dexamethasone therapy resulted in 20 of 25 objective responses for an overall response rate of 80% (complete remission + very good partial remission, 66%). Median overall survival was not reached. Median duration of response (progression-free survival) was 8 months. Eleven of 16 patients (68%) with ≥ VGPR still maintain a response at a median of 12 months versus 4 months for patients with < VGPR (PFS, overall survival; P = .0001). Grade 3/4 toxicities were mild in most of the patients. Conclusion: Bortezomib/PLD/dexamethasone combination is safe and effective in elderly patients with resistant-relapsing MM.