Maintenance in myeloma patients achieving complete response after upfront therapy: a pooled analysis

被引：9

作者：

Cerrato, Chiara ^{[1
]}

Di Raimondo, Francesco ^{[2
]}

De Paoli, Lorenzo ^{[3
,4
]}

Spada, Stefano ^{[1
]}

Patriarca, Francesca ^{[5
]}

Crippa, Claudia ^{[6
]}

Mina, Roberto ^{[1
]}

Guglielmelli, Tommasina ^{[7
]}

Ben-Yehuda, Dina ^{[8
]}

Oddolo, Daniela ^{[1
]}

Nozzoli, Chiara ^{[9
]}

Angelucci, Emanuele ^{[10
]}

Cascavilla, Nicola ^{[11
]}

Rizzi, Rita ^{[12
]}

Rocco, Stefano ^{[13
]}

Baldini, Luca ^{[14
]}

Ponticelli, Elena ^{[1
]}

Marcatti, Magda ^{[15
]}

Cangialosi, Clotilde ^{[16
]}

Caravita, Tommaso ^{[17
]}

Benevolo, Giulia ^{[18
]}

Ria, Roberto ^{[19
]}

Nagler, Arnon ^{[20
]}

Musto, Pellegrino ^{[21
]}

Tacchetti, Paola ^{[22
]}

Corradini, Paolo ^{[23
]}

Offidani, Massimo ^{[24
]}

Palumbo, Antonio ^{[1
,26
]}

Petrucci, Maria Teresa ^{[25
]}

Boccadoro, Mario ^{[1
]}

Gay, Francesca ^{[1
]}

机构：

[1] Univ Torino, Azienda Osped Univ Citta Salute & Sci Torino, Div Hematol, Myeloma Unit, Via Genova 3, I-10126 Turin, Italy

[2] Univ Catania, Azienda Policlin OVE, UOC Ematol, Catania, Italy

[3] Univ Piemonte Orientale, Div Hematol, Dept Translat Med, Novara, Italy

[4] Maggiore Hosp, Novara, Italy

[5] Univ Udine, Dipartimento Med, Udine, Italy

[6] Spedali Civili Brescia, Div Ematol, Brescia, Italy

[7] Dept Clin & Biol Sci, Orbassano, TO, Italy

[8] Hadassah Med Ctr, Dept Hematol, Jerusalem, Israel

[9] SODc Terapie Cellulari & Med Trasfus AOUC Careggi, Florence, Italy

[10] IRCCS Azienda Osped Univ San Martino, IST Ist Nazl Ric Canc, Genoa, Italy

[11] Hematol Casa Sollievo Sofferenza Hosp IRCCS, San Giovanni Rotondo, FG, Italy

[12] Univ Bari, Sect Hematol Transplantat, Dept Emergency & Organ Transplantat, Sch Med, Bari, Italy

[13] UOSC Ematol Trapianto AORN Cardarelli Napoli, Naples, Italy

[14] Univ Milan, Dept Oncol & Hematooncol, Osped Maggiore Policlin, Fdn IRCCS Ca Granda, Milan, Italy

[15] IRCCS Osped San Raffaele, UO Ematol & Trapianto Midollo, Milan, Italy

[16] Osped Riuniti Villa Sofia Cervello, Unita Operat Ematol I & UTMO, Palermo, Italy

[17] UOC Ematol Osped S Eugenio ASL RM2, Rome, Italy

[18] Citta Salute & Sci Hosp, SC Hematol, Turin, Italy

[19] Univ Bari Aldo Moro, Dept Biomed Sci, Sch Med, Internal Med G Baccelli, Bari, Italy

[20] Chaim Sheba Med Ctr, Div Hematol, Ramat Gan, Israel

[21] IRCCS Referral Canc Ctr Basilicata, Sci Direct, Rionero In Vulture, PZ, Italy

[22] Bologna Univ, Sch Med, Dept Expt Diagnost & Specialty Med, Seragnoli Inst Hematol, Bologna, Italy

[23] Univ Milan, Dept Oncol & Hematol, Milan, Italy

[24] AOU Osped Riuniti Ancona, Clin Ematol, Ancona, Italy

[25] Sapienza Univ Rome, Hematol, Rome, Italy

[26] Takeda, Zurich, Switzerland

来源：

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY | 2018年 / 144卷 / 07期

关键词：

Multiple myeloma (MM); Maintenance therapy; Newly diagnosed; Complete response (CR); Prognosis; STEM-CELL TRANSPLANTATION; BORTEZOMIB-MELPHALAN-PREDNISONE; MINIMAL RESIDUAL DISEASE; MULTIPLE-MYELOMA; INITIAL TREATMENT; THALIDOMIDE; LENALIDOMIDE; DEXAMETHASONE; METAANALYSIS; CRITERIA;

D O I：

10.1007/s00432-018-2641-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Maintenance demonstrated to improve survival in newly diagnosed multiple myeloma (NDMM) patients and the achievement of complete response (CR) is a strong predictor of survival. Nevertheless, the role of maintenance according to response after induction/consolidation has not been investigated so far. To evaluate the impact of maintenance according to response, we pooled together and retrospectively analyzed data from 955 NDMM patients enrolled in two trials (GIMEMA-MM-03-05 and RV-MM-PI-209). Primary endpoints were progression-free survival (PFS)1, PFS2 and overall survival (OS) of CR patients randomized to maintenance and no maintenance. Secondary endpoints were PFS1, PFS2 and OS in very good partial response/partial response (VGPR/PR) patients. Overall, 213 patients obtained CR after induction/consolidation, 118 received maintenance and 95 no maintenance. In patients achieving CR, maintenance significantly improved PFS1 (HR 0.50, P < 0.001), PFS2 (HR 0.58, P 0.02) and OS (HR 0.51, P 0.02) compared with no maintenance; the advantage was maintained across all the analyzed subgroups according to age, International Staging System (ISS) stage, cytogenetic profile and treatment. Similar features were seen in VGPR/PR patients. Maintenance prolonged survival in CR and in VGPR/PR patients. The benefit in CR patients suggests the importance of continuing treatment in patients with chemo-sensitive disease. The two source studies are registered at ClinicalTrials.gov: identification numbers NCT01063179 and NCT00551928.

引用

页码：1357 / 1366

页数：10

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