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

Rodríguez-Otero, P. ; Mateos, M.V. ; Martínez-López, J. ; Hernández, M.T. ; Ocio, E.M. ; Rosiñol, L. ; Martínez, R. ; Teruel, A.I. ; Gutiérrez, N.C. ; Bargay, J. ; Bengoechea, E. ; González, Y. ; de Oteyza, J.P. ; Gironella, M. ; Nuñez-Córdoba, J.M. ; Encinas, C. ; Martín, J. ; Cabrera, C. ; Palomera, L. (Universidad de Zaragoza) ; de Arriba, F. ; Cedena, M.T. ; Puig, N. ; Oriol, A. ; Paiva, B. ; Bladé, J. ; Lahuerta, J.J. ; San Miguel, J.F.

Resumen: 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.

Idioma: Inglés

DOI: 10.1038/s41408-019-0176-x

Año: 2019

Publicado en: BLOOD CANCER JOURNAL 9, 4 (2019), 36
ISSN: 2044-5385

Factor impacto JCR: 8.023 (2019)

Categ. JCR: ONCOLOGY rank: 25 / 244 = 0.102 (2019) - Q1 - T1
Categ. JCR: HEMATOLOGY rank: 6 / 76 = 0.079 (2019) - Q1 - T1

Factor impacto SCIMAGO: 2.924 - Oncology (Q1) - Hematology (Q1)

Financiación: info:eu-repo/grantAgreement/EUR/ERC/MYELOMANEXU-2015
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/CB16-12-00369
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/CB16-12-00377
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/CIBERONC
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/CD13-00340
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/G03-136
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI12-01761
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI12-02311
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI13-01469
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI14-01867
Financiación: info:eu-repo/grantAgreement/ES/ISCIII/FIS/PS09-01897-01370

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)