Original Research

Rate of complete response on weekly Bortezomib–Cyclophosphamide–Dexamethasone in newly diagnosed multiple myeloma: a 12‑week: A Real-World Evidence

Fatima Mehak Zia1
Department of Medical Oncology, INMOL Hospital, Lahore, Pakistan
Amber Ameen1
Department of Medical Oncology, INMOL Hospital, Lahore, Pakistan
Faryal Azhar1
Department of Medical Oncology, INMOL Hospital, Lahore, Pakistan
Rija Tariq1
Department of Medical Oncology, INMOL Hospital, Lahore, Pakistan
Mehwish Manzoor2
Mayo Hospital Lahore, Pakistan

✉ Correspondence: Fatima Mehak Zia Email: ziiscent@gmail.com

DOI https://doi.org/10.70302/jpsim.v6i4.2559
Volume: 6, Issue 4 Pages: 321–326 Published: 21 Nov 2025
Received: 27 May 2025 Revised: 23 Aug 2025 Accepted: 10 Nov 2025 Published Online: 21 Nov 2025

Abstract

Objective

This study aimed to assess the rate of complete response after three cycles (12 weeks) of weekly VCD and to observe toxicity and early progression.

Methods

We conducted a prospective, observational study at a tertiary cancer center in Lahore, Pakistan. Sixty newly diagnosed symptomatic MM patients received weekly VCD for three 28‑day cycles. Bortezomib 1.3 mg/m² was administered subcutaneously on days 1, 8, and 15, cyclophosphamide 300 mg/m² orally on days 1, 8, and 15, and dexamethasone 20 mg on days 1, 8, and 15. Responses were assessed at week 12 using International Myeloma Working Group (IMWG) criteria. Adverse events (AEs) were graded using CTCAE v5.0. The primary endpoint was the complete response (CR) rate. Secondary endpoints included overall response rate (ORR), very good partial response (VGPR) rate, and grade ≥3 toxicities.

Results

The cohort (median age 60 years) comprised 33 men and 27 women. Baseline International Staging System (ISS) distribution was 33.3 % ISS I, 30 % ISS II and 36.7 % ISS III. After 12 weeks, the ORR was 88.3 %. CR occurred in 10 patients (16.7 %), VGPR in 18 (30 %), partial response (PR) in 25 (41.7 %), minimal response (MR) in 3 (5 %), stable disease (SD) in 3 (5 %) and progressive disease (PD) in 1 (1.7 %). Grade ≥3 toxicities included neutropenia (10 %), anemia (6.7 %), thrombocytopenia (5 %), infections (3.3 %), and grade 3 peripheral neuropathy (1.7 %). There were no treatment‑related deaths.

Conclusions

Weekly VCD achieved a high ORR and acceptable safety at 12 weeks in this real‑world cohort. The CR rate compares favorably with published data for weekly VCD in elderly patients. Weekly dosing may reduce treatment burden and toxicity, making it suitable for resource‑limited settings. A longer follow‑up will determine the durability of the response and survival.

Keywords
Bortezomib Cyclophosphamide Dexamethasone Multiple Myeloma

How to Cite This Article

Zia FM, Ameen A, Azhar F, Tariq R, Manzoor M. Rate of complete response on weekly Bortezomib–Cyclophosphamide–Dexamethasone in newly diagnosed multiple myeloma: a 12‑week: A Real-World Evidence. J Pak Soc Intern Med. 2025;6(4):321–326. doi:10.70302/jpsim.v6i4.2559

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Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

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Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2025 Journal of Pakistan Society of Internal Medicine.
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