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Clinical Trial
. 2016 Jul 29;6(7):e453.
doi: 10.1038/bcj.2016.64.

Dose-dense and less dose-intense Total Therapy 5 for gene expression profiling-defined high-risk multiple myeloma

Y Jethava  1 , A Mitchell  2 , M Zangari  1 , S Waheed  1 , C Schinke  1 , S Thanendrarajan  1 , J Sawyer  1 , D Alapat  1 , E Tian  1 , C Stein  1 , R Khan  1 , C J Heuck  1 , N Petty  1 , D Avery  1 , D Steward  1 , R Smith  1 , C Bailey  1 , J Epstein  1 , S Yaccoby  1 , A Hoering  2 , J Crowley  2 , G Morgan  1 , B Barlogie  1 , F van Rhee  1
Affiliations
Clinical Trial

Dose-dense and less dose-intense Total Therapy 5 for gene expression profiling-defined high-risk multiple myeloma

Y Jethava et al. Blood Cancer J. .

Erratum in

Abstract

Multiple myeloma (MM) is a heterogeneous disease with high-risk patients progressing rapidly despite treatment. Various definitions of high-risk MM are used and we reported that gene expression profile (GEP)-defined high risk was a major predictor of relapse. In spite of our best efforts, the majority of GEP70 high-risk patients relapse and we have noted higher relapse rates during drug-free intervals. This prompted us to explore the concept of less intense drug dosing with shorter intervals between courses with the aim of preventing inter-course relapse. Here we report the outcome of the Total Therapy 5 trial, where this concept was tested. This regimen effectively reduced early mortality and relapse but failed to improve progression-free survival and overall survival due to relapse early during maintenance.

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Figures

Figure 1
Figure 1
Total Therapy 5 treatment schema.
Figure 2
Figure 2
Consort diagram of patients enrolled in TT5.
Figure 3
Figure 3
Outcomes for patients entered into TT5. (a) OS, (b) PFS, (c) CRD, (d) Cumulative incidence of response.
See this image and copyright information in PMC

References

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