Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature

Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials...

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Detalles Bibliográficos
Autores: Rodriguez-Otero, Paula, Mateos, Maria-Victoria, Martinez-Lopez, Joaquin, Hernández, Miguel-Teodoro, Ocio, Enrique M., Rosiñol, Laura, Martinez, Rafael, Teruel, Ana Isabel, Gutierrez, Norma C., Bargay Lleonart, Joan, Bengoechea, Enrique, Gonzalez, Yolanda, Perez de Oteyza, Jaime, Gironella, Mercedes, Nunez-Cordoba, Jorge M., Encinas, Cristina, Martin, Jesus, Cabrera, Carmen, Palomera, Luis, de Arriba, Felipe, Cedena, Maria Teresa, Puig, Noemi, Oriol, Albert, Paiva, Bruno, Bladé, Joan, Jose Lahuerta, Juan, San Miguel, Jesus F.
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Conselleria de Salut i Consum del Govern de les Illes Balears
Repositorio:Docusalut
Idioma:inglés
OAI Identifier:oai:docusalut.com:20.500.13003/17583
Acceso en línea:https://hdl.handle.net/20.500.13003/17583
Access Level:acceso abierto
Palabra clave:Multiple Myeloma
Aged
Male
Female
Humans
Monoclonal Gammopathy of Undetermined Significance
Humanos
Masculino
Femenino
Mieloma Múltiple
Anciano
Gammopatía Monoclonal de Relevancia Indeterminada
Descripción
Sumario:Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) >= 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb >= 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years.

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