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. 2019 Mar 18;9(4):36.
doi: 10.1038/s41408-019-0176-x.

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

Paula Rodríguez-Otero  1 , María Victoria Mateos  2 , Joaquín Martínez-López  3 , Miguel-Teodoro Hernández  4 , Enrique M Ocio  2 , Laura Rosiñol  5 , Rafael Martínez  6 , Ana-Isabel Teruel  7 , Norma C Gutiérrez  2 , Joan Bargay  8 , Enrique Bengoechea  9 , Yolanda González  10 , Jaime Pérez de Oteyza  11 , Mercedes Gironella  12 , Jorge M Nuñez-Córdoba  13 , Cristina Encinas  14 , Jesús Martín  15 , Carmen Cabrera  16 , Luis Palomera  17 , Felipe de Arriba  18 , María Teresa Cedena  3 , Noemí Puig  2 , Albert Oriol  19 , Bruno Paiva  1 , Joan Bladé  6 , Juan José Lahuerta  4 , Jesús F San Miguel  20
Affiliations

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

Paula Rodríguez-Otero et al. Blood Cancer J. .

Abstract

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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Conflict of interest statement

P.R.-O.: has served on the speaker’s bureau and as a member of advisory boards for Janssen, Celgene, BMS, and Takeda. M.V.M.: has declared consultancy for: Janssen, Celgene, Takeda, and Amgen. E.M.O.: has declared consultancy for or honoraria from: Mundipharma, Celgene, Amgen, Novartis, Takeda, AbbVie, BMS, and Janssen. B.P.: has declared grants from Celgene, EngMab, Sanofi, and Takeda, and received honoraria for lectures and advisory boards from Amgen, BMS, Celgene, Janssen, Takeda, Sanofi, and Novartis. J.F.S.M.: received honoraria as part of Advisory boards from Celgene, Novartis, Millenium, Janssen, Amgen, MSD, Sanofi, and BMS. A.O.: has served as a member of advisory boards for Janssen and Celgene. J.B.: received honoraria for lectures and advisory boards from Celgene and Janssen and grant support from Janssen. L.R.: received honoraria from Janssen and Celgene. The remaining authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves of overall survival in long-term survivor group as compared with the remainder
See this image and copyright information in PMC

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