Prognostic and predictive performance of R-ISS with SKY92 in older patients with multiple myeloma: The HOVON-87/NMSG-18 trial
| Autor: | Annemiek Broijl, Mark-David Levin, Annette W.G. van der Velden, Bronno van der Holt, Pieter Sonneveld, Martin H. van Vliet, Mark van Duin, Sonja Zweegman, H. Berna Beverloo, Jasper Koenders, Anders Waage, Marian Stevens-Kroef, Belinda Dumee, Markus Hansson, Rowan Kuiper, Michael Vermeulen, Heleen Visser-Wisselaar, Erik H. van Beers |
|---|---|
| Přispěvatelé: | Hematology, CCA - Cancer Treatment and quality of life, Clinical Genetics |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] Risk groups All institutes and research themes of the Radboud University Medical Center Older patients Standard Risk Internal medicine medicine Humans Lenalidomide Multiple myeloma Aged Hematology Lymphoid Neoplasia business.industry medicine.disease Prognosis Thalidomide Relative risk business Multiple Myeloma medicine.drug |
| Zdroj: | BLOOD ADVANCES, 4(24), 6298-6309. American Society of Hematology Blood Adv Kuiper, R, Zweegman, S, van Duin, M, van Vliet, M H, van Beers, E H, Dumee, B, Vermeulen, M, Koenders, J, van der Holt, B, Visser-Wisselaar, H, Hansson, M, van der Velden, A W G, Berna Beverloo, H, Stevens-Kroef, M, Levin, M D, Broijl, A, Waage, A & Sonneveld, P 2020, ' Prognostic and predictive performance of R-ISS with SKY92 in older patients with multiple myeloma : The HOVON-87/NMSG-18 trial ', BLOOD ADVANCES, vol. 4, no. 24, pp. 6298-6309 . https://doi.org/10.1182/bloodadvances.2020002838 Blood Advances, 4, 24, pp. 6298-6309 Blood advances, 4(24), 6298-6309. American Society of Hematology Blood Advances, 4, 6298-6309 |
| ISSN: | 2473-9529 6298-6309 |
| DOI: | 10.1182/bloodadvances.2020002838 |
| Popis: | The standard prognostic marker for multiple myeloma (MM) patients is the revised International Staging System (R-ISS). However, there is room for improvement in guiding treatment. This applies particularly to older patients, in whom the benefit/risk ratio is reduced because of comorbidities and subsequent side effects. We hypothesized that adding gene-expression data to R-ISS would generate a stronger marker. This was tested by combining R-ISS with the SKY92 classifier (SKY-RISS). The HOVON-87/NMSG-18 trial (EudraCT: 2007-004007-34) compared melphalan-prednisone-thalidomide followed by thalidomide maintenance (MPT-T) with melphalan-prednisone-lenalidomide followed by lenalidomide maintenance (MPR-R). From this trial, 168 patients with available R-ISS status and gene-expression profiles were analyzed. R-ISS stages I, II, and III were assigned to 8%, 75%, and 7% of patients, respectively (3-year overall survival [OS] rates: 80%, 65%, 33%, P = 8 × 10−3). Using the SKY92 classifier, 13% of patients were high risk (HR) (3-year OS rates: standard risk [SR], 70%; HR, 28%; P < .001). Combining SKY92 with R-ISS resulted in 3 risk groups: SKY-RISS I (SKY-SR + R-ISS-I; 15%), SKY-RISS III (SKY-HR + R-ISS-II/III; 11%), and SKY-RISS II (all other patients; 74%). The 3-year OS rates for SKY-RISS I, II, and III are 88%, 66%, and 26%, respectively (P = 6 × 10−7). The SKY-RISS model was validated in older patients from the CoMMpass dataset. Moreover, SKY-RISS demonstrated predictive potential: HR patients appeared to benefit from MPR-R over MPT-T (median OS, 55 and 14 months, respectively). Combined, SKY92 and R-ISS classify patients more accurately. Additionally, benefit was observed for MPR-R over MPT-T in SKY92-RISS HR patients only. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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