In October 2012, federal funding for bortezomib was expanded to cover first line use in symptomatic MM regardless of transplant eligibility. Due to the high cost of bortezomib it is important to compare published data with ‘real life’ outcomes. We aim to evaluate the use of Bortezomib in Queensland public hospitals and compare outcomes with the published trial data.
This study is a retrospective audit of Bortezomib use in non-transplant eligible multiple myeloma patients in four Queensland public hospitals from October 2012 to December 2016. Chemotherapy treatment data was retrieved from the oncology information system, Charm. This included treatment pathways, dosing and adjustments, treatment duration, patient parameters and survival. Pathology and clinical information including organ function, response rates, adverse events and hospitalisations were obtained from the pathology system Auslab and a medical chart audit at each site.
31 eligible patients have been audited from 2 of the sites, Toowoomba Hospital and Princess Alexandra Hospital. Patients were treated with either CVD (bortezomib, cyclophosphamide, dexamethasone) or VMP (bortezomib, melphalan, prednisolone) regimens. A small number of patients had the cytotoxic agent omitted. The majority of cycles were weekly versions of these. The median age of the patients was 75 years. The median cumulative dose was 26.37 mg/msq which appears to be lower than that reported from several key trials using VMP (38.5, 42.1, 40.3, 32.9 mg/msq).1
Preliminary analysis indicates that multiple myeloma patients in Queensland public hospitals achieve lower exposure to bortezomib compared to data published in the literature. Data collection and analysis are ongoing.