Adding bortezomib to combination therapy with lenalidomide and dexamethasone may improve progression-free and overall survival in patients with newly diagnosed multiple myeloma. The study findings were published in Lancet.

In an open-label trial, researchers studied 471 patients from Southwest Oncology Group and National Clinical Trial Network sites from April 2008–February 2013. They randomized the patients to receive bortezomib plus lenalidomide and dexamethasone (VRd) or lenalidomide and dexamethasone (Rd) alone.

Median overall survival was 75 months in the VRd group and 64 months in the Rd group. Overall response rates were 82% for VRd and 72% for Rd; complete response was 16% for VRd and 8% for Rd. Grade 3 or higher adverse events, including anemia, lymphopenia, neutropenia, thrombocytopenia, fatigue, sensory neuropathy, hyperglycemia, thrombosis, hypokalemia, muscle weakness, diarrhea, and dehydration, were reported in 82% of patients in the VRd group versus 75% in the Rd group. These resulted in treatment discontinuation in 23% of patients in the VRd group versus 10% in the Rd group.