Real-world data on Len/Dex combination at second-line therapy of multiple myeloma: treatment at biochemical relapse is a significant prognostic factor for progression-free survival

Autor: Ioannis Adamopoulos, Maria Kotsopoulou, Evangelos Terpos, Anna Kioumi, Eftychia Nikolaou, Panagiotis Zikos, Eleni Papadaki, Panayiotis Repousis, Eirini Katodritou, Georgios Vasilopoulos, Vassiliki Douka, Evangelos Briasoulis, Emmanouil Spanoudakis, Anthi Aktypi, Dimitrios Gogos, Sosana Delimpasi, Despoina Fotiou, Aikaterini Megalakaki, Eleftheria Hatzimichael, Kyriaki Kokoviadou, Marie-Christine Kyrtsonis, Achilles Anagnostopoulos, Argiris Symeonidis, Vassiliki Pappa, Evlambia Giannopoulou, Despoina Timotheatou, Nikolaos Giannakoulas, D.S. Kyriakou
Rok vydání: 2018
Předmět:
Oncology
Adult
Male
medicine.medical_specialty
030204 cardiovascular system & hematology
Biochemical relapse
Dexamethasone
Disease-Free Survival
Lenalidomide-dexamethasone
03 medical and health sciences
0302 clinical medicine
Autologous stem-cell transplantation
Recurrence
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Biomarkers
Tumor
Humans
Progression-free survival
Practice Patterns
Physicians'
Lenalidomide
Multiple myeloma
Aged
Retrospective Studies
Aged
80 and over
Hematology
Bortezomib
business.industry
Symptomatic relapse
Correction
General Medicine
Middle Aged
medicine.disease
Prognosis
Combined Modality Therapy
Survival Analysis
3. Good health
Thalidomide
Clinical trial
Chemotherapy
Adjuvant
030220 oncology & carcinogenesis
Original Article
Female
business
Multiple Myeloma
medicine.drug
Zdroj: Annals of Hematology
ISSN: 1432-0584
Popis: We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second line, according to routine clinical practice in Greece. First-line treatment included bortezomib-based (63.3%) or immunomodulatory drug-based (34.8%) therapies; 25% of patients underwent autologous stem cell transplantation. Overall response rate was 73.4% (17.8% complete response and 23.7% very good partial response); median time to best response was 6.7 months. Overall, median PFS and 12-month PFS rate was 19.2 months and 67.6%, respectively. 67.5% of patients had biochemical relapse and 32.5% had clinical relapse prior to initiation of Len/Dex. Median PFS was 24 months for patients treated at biochemical relapse vs. 13.2 months for those treated at clinical relapse (HR:0.63, p = 0.006) and the difference remained significant after adjustment for other prognostic factors. Type of relapse was the strongest prognostic factor for PFS in multivariate analysis. These real-world data confirm the efficacy of Len/Dex combination at first relapse; more importantly, it is demonstrated for the first time outside a clinical trial setting that starting therapy with Len/Dex at biochemical, rather than at clinical relapse, is a significant prognostic factor for PFS, inducing a 37% reduction of the probability of disease progression or death.
Databáze: OpenAIRE
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