@article{3086772,
    title = "Primary failure of bortezomib in newly diagnosed multiple myeloma-understanding the magnitude, predictors, and significance",
    author = "Cohen, Y.C. and Joffe, E. and Benyamini, N. and Dimopoulos, M.A. and Terpos, E. and Trestman, S. and Held-Kuznetsov, V. and Avivi, I. and Kastritis, E.",
    journal = "Clinical Lymphoma Myeloma and Leukemia",
    year = "2016",
    volume = "57",
    number = "6",
    pages = "1382-1388",
    publisher = "Taylor and Francis Ltd.",
    doi = "10.3109/10428194.2015.1121258",
    keywords = "bortezomib;  cyclophosphamide;  dexamethasone;  antineoplastic agent;  bortezomib;  paraprotein, adult;  aged;  Article;  autologous stem cell transplantation;  cancer combination chemotherapy;  cancer mortality;  cancer patient;  cancer prognosis;  controlled study;  corticosteroid therapy;  drug response;  drug treatment failure;  female;  follow up;  human;  induction chemotherapy;  major clinical study;  male;  medical record review;  multiple myeloma;  newly diagnosed multiple myeloma;  newly diagnosed multiple myeloma;  overall survival;  priority journal;  retrospective study;  salvage therapy;  cancer staging;  drug resistance;  hematopoietic stem cell transplantation;  middle aged;  mortality;  multimodality cancer therapy;  multiple myeloma;  prognosis;  proportional hazards model;  remission;  treatment failure;  treatment outcome;  tumor recurrence;  very elderly, Aged;  Aged, 80 and over;  Antineoplastic Agents;  Bortezomib;  Combined Modality Therapy;  Drug Resistance, Neoplasm;  Female;  Hematopoietic Stem Cell Transplantation;  Humans;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Recurrence, Local;  Neoplasm Staging;  Paraproteins;  Prognosis;  Proportional Hazards Models;  Remission Induction;  Treatment Failure;  Treatment Outcome",
    abstract = "Botezomib-based induction is highly effective for the treatment of newly diagnosed multiple myeloma (NDMM). We investigated the outcomes of NDMM patients who failed to respond to bortezomib-based induction in a real-life clinical setting. In a cohort of 295 consecutive NDMM patients in 3 medical centers, 74 (25%) failed to achieve at least partial response after 4 induction cycles, and were classified as non-responsive. Compared to induction responders, they were older, more frequently anemic, had a higher incidence of del17p and ISS-3, and a worse performance status. In multivariable analysis, bortezomib-based induction failure occurred in 25% of patients and was the strongest independent factor predicting mortality with a 5-fold hazard ratio (95% CI 1.44-8.68). Three-year overall survival in responsive vs. non-responsive patients were 76% vs. 53%, respectively (p < 0.0001). Survival from time of salvage second-line treatment was significantly shorter among induction non-responders vs. responders (25 months vs. not-reached, p = 0.024). © 2015 Taylor & Francis."
}