According to research published early online in the Journal of Clinical Oncology, use of short-term bortezomib induction improves outcome of multiple myeloma (MM) patients with the t(4;14) chromosomal abnormality but not the outcome of patients with the del(17p) chromosomal abnormality.

Researchers evaluated responses of 507 patients with newly diagnosed MM who received four cycles of bortezomib-dexamethasone induction therapy before high-dose melphalan. Additionally, all patients were analysed for both the t(4;14) and del(17p) chromosomal abnormalities.

The researchers reported the following results:
• In terms of overall survival (OS), a higher death rate was observed among patients with t(4;14) compared with patients lacking this abnormality (P<0.002). Similar data were observed for patients with del(17p).
• Median event-free survival (EFS) time was 14 months for patients with del(17p) in more than 60%of the plasma cells compared with 36 months for patients lacking del(17p) or with del(17p) in less than 60% of the plasma cells (P < 0.001).
• For t(4;14)-positive patients the median EFS was 28 months compared with 16 months for patients treated with vincristine, doxorubicin, and dexamethasone (VAD) induction (P<0.001)

The researchers concluded that bortezomib improves the prognosis (in terms of both EFS and OS) of patients with t(4;14), compared with patients treated with vincristine, doxorubicin, and dexamethasone induction therapy. In contrast, no improvement was observed for del(17p) patients.