Background: Bortezomib is an antineoplastic agent that acts through protease inhibition. Since, its approval in 2003 by U.S. Food and Drug administration, it has been used religiously for multiple myeloma. There is no current population based study that assesses the survival benefit in multiple myeloma from bortezomib. We conducted a population based study to evaluate the relative survival rates in multiple myeloma patients in pre and post-Bortezomib era in the United States.

Methods: We analyzed the Surveillance, Epidemiology, and End Results (SEER) 18 registry database to compare five-year relative survival rates (RS) among multiple myeloma patients. The study arms were categorized by gender (male and female), race (Caucasians and African-Americans) and age (20-59, ≥60 years). The RS were compared between pre-bortezomib era (1991-2002) and post-bortezomib era (2004-2011). The survival rate accompanied standard errors and the statistical significance was defined as p value <0.05.

Results: The database comprised of 57,328 patients. The RS have improved significantly during post-bortezomib era in all cohorts under consideration. There was no significant difference in survival rate between male and female and between the African American and Caucasian. However, the relative survival was much better with the young adult (20-59 years) as compared to adult ≥60 years. The table detailing the relative survival is given below.

Conclusion: The Primary treatment protocols for Multiple Myeloma have changed dramatically since the approval of Bortezomib in 2003. Other novel agents introduced in the last decade include thalidomide, Lenalidomide and liposomal doxorubicin that are used in conjunction with Bortezomib. Survival trends continue to improve and we believe this modest improvement in survival rate is mainly due to the introduction of Bortezomib and other novel agents. The next challenge is to find new drugs which would prevent relapses and further prolong survival.

Abstract 2639. Table.
Study armSubclass of cohortsPre-bortezomib era (1991-2002)Post- bortezomib era (2004-2011)Z scoreP Value
NRS (%)Relative Standard Error (SE) (%)NRS (%)Relative Standard Error (SE) (%)
Gender Male 13,066 34.6 0.5 17,765 46.1 0.6 15.904 <0.0001 
Female 11,580 32.1 0.5 14,917 43.7 0.6 14.765 <0.0001 
Race Caucasian 18,836 32.9 0.4 23,981 45.0 0.5 19.259 <0.0001 
African American 4,274 34.7 0.8 6,391 45.1 0.9 8.488 <0.0001 
Age group 20-59 6,358 48.1 0.6 9,439 60.2 0.7 12.920 <0.0001 
>=60 18,288 27.8 0.4 23,243 38.4 0.5 16.606 <0.0001 
Study armSubclass of cohortsPre-bortezomib era (1991-2002)Post- bortezomib era (2004-2011)Z scoreP Value
NRS (%)Relative Standard Error (SE) (%)NRS (%)Relative Standard Error (SE) (%)
Gender Male 13,066 34.6 0.5 17,765 46.1 0.6 15.904 <0.0001 
Female 11,580 32.1 0.5 14,917 43.7 0.6 14.765 <0.0001 
Race Caucasian 18,836 32.9 0.4 23,981 45.0 0.5 19.259 <0.0001 
African American 4,274 34.7 0.8 6,391 45.1 0.9 8.488 <0.0001 
Age group 20-59 6,358 48.1 0.6 9,439 60.2 0.7 12.920 <0.0001 
>=60 18,288 27.8 0.4 23,243 38.4 0.5 16.606 <0.0001 
View Large

Total: male and female: 1991-2002; 24,646, RS 33.4%; SE 0.3%; 2004-2011; 32,682, RS 45.0%, SE 0.4%; Z score 21.766, P value <0.0001.

Disclosures

No relevant conflicts of interest to declare.

Topics:
bortezomib, multiple myeloma, seer program, liposomes, antineoplastic agents, doxorubicin, endopeptidases, lenalidomide, peptide hydrolases, thalidomide

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2014 by The American Society of Hematology
2014
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