Induction regimens for multiple myeloma (MM) commonly include bortezomib, which has typically been administered twice weekly despite studies demonstrating comparable efficacy and less peripheral neuropathy (PN) with once-weekly bortezomib. We aimed to analyze the real-world prevalence and efficacy of once-weekly versus twice-weekly bortezomib regimens in newly diagnosed MM. We analyzed 2497 US patients aged 18–70 years treated with commercial first-line bortezomib using nationwide Flatiron Health electronic health record-derived data, including 910 (36.4%) patients who received twice-weekly and 1522 (63.2%) who received once-weekly bortezomib. Once-weekly bortezomib use increased over time, from 57.7% in 2017 to 73.1% in 2022. Multivariate analysis identified worsened performance status and more recent year of diagnosis with higher odds of receiving once-weekly bortezomib. Real-world progression-free survival (median 37.2 months with once-weekly versus 39.6 months with twice-weekly, p = 0.906) and overall survival (medians not reached in either cohort, p = 0.800) were comparable. PN rates were higher in patients receiving twice-weekly bortezomib (34.7% versus 18.5%, p < 0.001). In conclusion, once-weekly bortezomib is clearly associated with similar efficacy and fewer toxicities compared to twice-weekly bortezomib. Our findings support once-weekly bortezomib as a standard-of-care regimen for newly diagnosed patients with MM.

多发性骨髓瘤 (MM) 的诱导方案通常包括硼替佐米 (bortezomib)，尽管研究表明与每周一次的硼替佐米 (bortezomib) 疗效相当，且周围神经病变 (PN) 较少，但通常每周给药两次。我们的目的是分析每周一次与每周两次硼替佐米治疗方案在新诊断的 MM 中的实际患病率和疗效。我们利用全国范围内的 Flatiron Health 电子健康记录数据，分析了 2497 名接受商业一线硼替佐米治疗的美国患者，其中包括 910 名 (36.4%) 每周接受两次硼替佐米治疗的患者和 1522 名 (63.2%) 接受过一次硼替佐米治疗的患者。每周一次硼替佐米。随着时间的推移，每周一次的硼替佐米使用率不断增加，从 2017 年的 57.7% 增加到 2022 年的 73.1%。多变量分析发现，体力状态恶化，且最近一年的诊断表明，接受每周一次硼替佐米的几率更高。现实世界的无进展生存期（每周一次的中位生存期为 37.2 个月，每周两次的中位生存期为 39.6 个月，p  = 0.906）和总生存期（任一队列均未达到中位生存期，p  = 0.800）具有可比性。每周两次硼替佐米治疗的患者的 PN 率较高（34.7% 对比 18.5%，p  < 0.001）。总之，与每周两次硼替佐米相比，每周一次硼替佐米显然具有相似的疗效和更少的毒性。我们的研究结果支持每周一次的硼替佐米作为新诊断的 MM 患者的标准治疗方案。