A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial

被引：169

作者：

Facon, Thierry ^{[1
]}

Dimopoulos, Meletios A. ^{[2
]}

Meuleman, Nathalie ^{[3
]}

Belch, Andrew ^{[4
]}

Mohty, Mohamad ^{[5
]}

Chen, Wen-Ming ^{[6
]}

Kim, Kihyun ^{[7
]}

Zamagni, Elena ^{[8
]}

Rodriguez-Otero, Paula ^{[9
]}

Renwick, William ^{[10
]}

Rose, Christian ^{[11
]}

Tempescul, Adrian ^{[12
]}

Boyle, Eileen ^{[2
]}

Manier, Salomon ^{[2
]}

Attal, Michel ^{[13
]}

Moreau, Philippe ^{[14
]}

Macro, Margaret ^{[15
]}

Leleu, Xavier ^{[16
]}

Chretien, Marie Lorraine ^{[17
]}

Ludwig, Heinz ^{[18
]}

Guo, Shien ^{[19
]}

Sturniolo, Michael ^{[20
]}

Tinel, Antoine ^{[21
]}

Monzini, Mara Silvia ^{[20
]}

Costa, Bruno ^{[21
]}

Houck, Vanessa ^{[20
]}

Hulin, Cyrille ^{[22
]}

Mary, Jean Yves ^{[23
]}

机构：

[1] Univ Lille, CHU Lille, Serv Malad Sang, F-59000 Lille, France

[2] Natl & Kapodistrian Univ Athens, Athens, Greece

[3] Univ Libre Bruxelles, Jules Bordet Inst, Brussels, Belgium

[4] Cross Canc Inst, Edmonton, AB, Canada

[5] St Antoine Hosp, Dept Haematol, Paris, France

[6] Capital Med Univ, Beijing Chaoyang Hosp, Dept Hematol, Beijing, Peoples R China

[7] Sungkyunkwan Univ, Samsung Med Ctr, Seoul, South Korea

[8] Azienda Osped Univ, Bologna, Italy

[9] Univ Navarra, Pamplona, Spain

[10] Western Hlth, Melbourne, Vic, Australia

[11] Univ Catholique Lille, Hop St Vincent Paul, Lille, France

[12] Ctr Hosp Univ, Brest, France

[13] Inst Univ Canc Toulouse Oncopole, Toulouse, France

[14] Univ Hosp Hotel Dieu, Nantes, France

[15] Ctr Hosp Univ, Caen, France

[16] Hop La Mileterie, Poitiers, France

[17] CHU Dijon, Dijon, France

[18] Wilhelminen Hosp, Vienna, Austria

[19] Evidera, Waltham, MA USA

[20] Celgene Corp, Summit, NJ USA

[21] Celgene Int Sarl, Boudry, Switzerland

[22] Ctr Hosp Univ, Bordeaux, France

[23] Hop St Louis, Paris, France

来源：

LEUKEMIA | 2020年 / 34卷 / 01期

关键词：

QUALITY-OF-LIFE; GERIATRIC ASSESSMENT; PERFORMANCE STATUS; SURVIVAL; SCORE; DEXAMETHASONE; LENALIDOMIDE;

D O I：

10.1038/s41375-019-0539-0

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores for age, Charlson Comorbidity Index (CCI), and Eastern Cooperative Oncology Group performance status (ECOG PS), instead of the EQ-5D quality-of-life questionnaire, as previously reported. ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%). Frail patients experienced worse progression-free and overall survival vs nonfrail patients. Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III). Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events. Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS-containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients.

引用

页码：224 / 233

页数：10

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