ArticleInternational journal of medical sciences2025
Advantage of Tolerability following Arsenic Trioxide-VTD vs VRD in newly diagnosed multiple myeloma patients: a prospective, open-label study.
Article in International journal of medical sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Multiple myeloma is the second most common hematologic malignancy in older patients. The standard front-line VRD regimen (bortezomib/lenalidomide/dexamethasone) achieves high efficacy but is associated with significant toxicity, leading to infections, bone marrow suppression, and treatment discontinuation in approximately 20% of patients. Alternative regimens with reduced toxicity are needed for this demographic. Prior studies suggest adding arsenic trioxide to bortezomib/dexamethasone (BD) enhances remission depth with acceptable safety, while bortezomib/thalidomide/dexamethasone (VTD) offers reduced toxicity, but lower efficacy compared to VRD. This study evaluates the efficacy, safety, and cost-effectiveness of an arsenic trioxide-VTD regimen (AVTD) versus VRD in newly diagnosed multiple myeloma (NDMM) patients. Among 116 participants, AVTD demonstrated comparable efficacy to VRD but significantly reduced infection rates (14.0% vs. 40.7%, P < 0.001) and severe bone marrow suppression (0% vs. 11.9%, P = 0.013). Subgroup analysis of patients >60 years yielded consistent results. Additionally, AVTD was associated with lower treatment costs. In conclusion, the AVTD regimen offers a safer, more cost-effective alternative to VRD for NDMM, particularly in older adult patients, without compromising treatment efficacy.
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