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. 2023 Mar 2;15(5):1558.
doi: 10.3390/cancers15051558.

Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma

Borja Puertas  1 , Verónica González-Calle  1 , Eduardo Sobejano-Fuertes  2 , Fernando Escalante  3 , José A Queizán  4 , Abelardo Bárez  5 , Jorge Labrador  6 , José María Alonso-Alonso  7 , Alfonso García de Coca  8 , Alberto Cantalapiedra  9 , Teresa Villaescusa  10 , Carlos Aguilar-Franco  11 , Elena Alejo-Alonso  1 , Beatriz Rey-Bua  1 , Lucía López-Corral  1 , Ramón García-Sanz  1 , Noemi Puig  1 , Norma C Gutiérrez  1 , María-Victoria Mateos  1
Affiliations

Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma

Borja Puertas et al. Cancers (Basel). .

Abstract

(1) Background: New therapeutic strategies have improved the prognosis of multiple myeloma (MM), changing the accepted view of this disease from being incurable to treatable. (2) Methods: We studied 1001 patients with MM between 1980 and 2020, grouping patients into ten-year periods by diagnosis 1980-1990, 1991-2000, 2001-2010 and 2011-2020. (3) Results: After 65.1 months of follow-up, the median OS of the cohort was 60.3 months, and OS increased significantly over time: 22.4 months in 1980-1990, 37.4 months in 1991-2000, 61.8 months in 2001-2010 and 103.6 months in 2011-2020 (p < 0.001). Using novel agents in the front-line setting for myeloma patients yielded a significantly better OS than in those treated with conventional therapies, especially when combinations of at least two novel agents were used. The median OS of patients treated with the combination of at least two novel agents in induction was significantly prolonged compared to those treated with a single novel agent or conventional therapy in induction: 143.3 vs. 61.0 vs. 42.2 months (p < 0.001). The improvement was apparent in all patients regardless of age at diagnosis. In addition, 132 (13.2%) patients were long-term survivors (median OS ≥ 10 years). Some independent clinical predictors of long-term survival were identified: ECOG < 1, age at diagnosis ≤ 65 years, non-IgA subtype, ISS-1 and standard-risk cytogenetic. Achieving CR and undergoing ASCT were positively associated with >10 years of survival. (4) Conclusions: The combination of novel agents appears to be the main factor for the improvement in survival in MM, which is becoming a chronic and even curable disease in a subtype of patients without high-risk features.

Keywords: long survivors; novel agents; survival.

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Conflict of interest statement

B.P. has received honoraria from Janssen and Aptitude Health. V.G.-C. has received honoraria from Janssen and Celgene, research funding from Janssen; and consulting or advisory roles for Prothena and Janssen. E.S.F. has received speaker’s fees from Amgen and Janssen and consultancies from Janssen. F.E.-B. has received speaker’s fees from Janssen, Sanofi, Amgen and Sanofi, and honoraria from consulting or advisory roles from Janssen, Biogene, Sanofi, GSK, Takeda, Amgen y BMS. EAA has received honoraria from Janssen. BRB has received speaker’s fees from Janssen. RGS has received honoraria from Janssen, Takeda and Amgen; and has received research funding from Gilead Sciences and Incyte. NP has received honoraria for consulting or advisory roles from Amgen, Celgene, Janssen, Takeda, The Binding Site, GSK and Sanofi. NGG has received honoraria from Janssen and Amgen. M.-V.M. has received honoraria derived from lectures and advisory boards from Janssen, BMS-Celgene, Amgen, Takeda, Abbvie, Sanofi, Oncopeptides, Adaptive, Roche, Pfizer, Regeneron, GSK, Bluebird Bio, Sea-Gen. The remaining authors declare no competing financial interests.

Figures

Figure 1
Figure 1
Overall survival by decades. Abbreviations: CI: confidence interval; HR: hazard ratio.
Figure 2
Figure 2
Overall survival by decades and age at diagnosis: (A) ≤70 years and (B) >70 years. Abbreviations: CI: confidence interval; HR: hazard ratio.
Figure 3
Figure 3
Overall survival by induction therapy. Abbreviations: CI: confidence interval; HR: hazard ratio.
Figure 4
Figure 4
Overall survival by induction therapy and age at diagnosis: (A) ≤70 years and (B) >70 years. Abbreviations: CI: confidence interval; HR: hazard ratio.
See this image and copyright information in PMC

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