| Autor: |
Bart Barlogie, Guido Tricot, Antje Hoering, Yazan Alsayed, Abid Mohiuddin, Klaus Hollmig, Maurizio Zangari, Mauricio Pineda-Roman, Elias Anaissie, Frits van Rhee, Joshua Epstein, John Crowley, Fenghuang Zhan, John D. Shaughnessy, Jeffrey Haessler |
| Rok vydání: |
2023 |
| DOI: |
10.1158/1078-0432.c.6518308 |
| Popis: |
Experimental Design: To determine whether the clinical benefit of complete remission (CR) may depend on prognostic subgroups of patients with multiple myeloma.Patients and Methods: Newly diagnosed patients with myeloma received a tandem autotransplant regimen. Using multivariate regression analyses, we examined the prognostic implications of time-dependent onset of CR on overall survival and event-free survival in the context of standard prognostic factors (SPF) and gene expression profiling–derived data available for 326 patients.Results: CR benefited patients regardless of risk status when only SPFs were examined. With knowledge of gene array data, a survival (and event-free survival) benefit of CR only pertained to the small high-risk subgroup of 13% of patients (hazard ratio, 0.23; P = 0.001), whereas the majority of patients with low-risk disease had similar survival expectations whether or not CR was achieved (hazard ratio, 0.68; P = 0.128).Conclusions: Access to gene expression information permitted the recognition of a small very high-risk subgroup of 13% of patients, in whom prolonged survival critically depended on achieving CR. Absence of such benefit in the remainder should lead to a reassessment of clinical trial designs that rely on this end point as a surrogate for long-term prognosis. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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