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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\u201370 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, <jats:italic>p<\/jats:italic>\u2009=\u20090.906) and overall survival (medians not reached in either cohort, <jats:italic>p<\/jats:italic>\u2009=\u20090.800) were comparable. PN rates were higher in patients receiving twice-weekly bortezomib (34.7% versus 18.5%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). 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.<\/jats:p>","DOI":"10.1038\/s41408-024-01034-6","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T08:24:31Z","timestamp":1711095871000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Once-weekly versus twice-weekly bortezomib in newly diagnosed multiple myeloma: a real-world analysis"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7128-1255","authenticated-orcid":false,"given":"Fieke W.","family":"Hoff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3781-5441","authenticated-orcid":false,"given":"Rahul","family":"Banerjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9462-6316","authenticated-orcid":false,"given":"Adeel M.","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"McCaughan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoliang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4442-1742","authenticated-orcid":false,"given":"James","family":"Roose","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6531-9595","authenticated-orcid":false,"suffix":"Jr.","given":"Larry D.","family":"Anderson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Cowan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5862-1833","authenticated-orcid":false,"given":"S. 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XW: Employment: Flatiron Health, Inc. (independent subsidiary of the Roche Group), stock ownership, Roche. JR: Employment: Flatiron Health, Inc. (independent subsidiary of the Roche Group), stock ownership, Roche. LDA Jr: Consulting: Janssen, Celgene, BMS, Amgen, GSK, AbbVie, Beigene, Cellectar, Sanofi, Prothena. Research: BMS, Celgene, GSK, Janssen, Abbvie. AJC: Consulting: BMS, Adaptive; Research: Adaptive Biotechnologies, Harpoon, Nektar, BMS, Janssen, Sanofi, AbbVie. GK: Consulting: BMS, Arcellx, Sanofi, Janssen, Cellectar, Pfizer, Kedrion; Research: BMS, Janssen, Abbvie. The remaining authors have no disclosures to report.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"52"}}