TY - JOUR
T1 - Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents
T2 - Analysis of 1175 patients
AU - Gay, Francesca
AU - Larocca, Alessandra
AU - Wijermans, Pierre
AU - Cavallo, Federica
AU - Rossi, Davide
AU - Schaafsma, Ron
AU - Genuardi, Mariella
AU - Romano, Alessandra
AU - Liberati, Anna Marina
AU - Siniscalchi, Agostina
AU - Petrucci, Maria T.
AU - Nozzoli, Chiara
AU - Patriarca, Francesca
AU - Offidani, Massimo
AU - Ria, Roberto
AU - Omedè, Paola
AU - Bruno, Benedetto
AU - Passera, Roberto
AU - Musto, Pellegrino
AU - Boccadoro, Mario
AU - Sonneveld, Pieter
AU - Palumbo, Antonio
PY - 2011/3/17
Y1 - 2011/3/17
N2 - Complete response (CR) was an uncommon event in elderly myeloma patients until novel agents were combined with standard oral melphalan-prednisone. This analysis assesses the impact of treatment response on progression-free survival (PFS) and overall survival (OS). We retrospectively analyzed 1175 newly diagnosed myeloma patients, enrolled in 3 multicenter trials, treated with melphalanprednisone alone (n = 332), melphalan-prednisone-thalidomide (n = 332), melphalanprednisone-bortezomib (n = 257), or melphalan-prednisone-bortezomib- thalidomide (n = 254). After a median follow-up of 29 months, the 3-year PFS andOSwere 67% and 27% (hazard ratio = 0.16; P < .001), and 91% and 70% (hazard ratio = 0.15; P < .001) in patients who obtained CR and in those who achieved very good partial response, respectively. Similar results were observed in patients older than 75 years. Multivariate analysis confirmed that the achievement of CR was an independent predictor of longer PFS and OS, regardless of age, International Staging System stage, and treatment. These findings highlight a significant association between the achievement of CR and long-term outcome, and support the use of novel agents to achieve maximal response in elderly patients, including those more than 75 years. This trial was registered at www.clinicaltrials.gov as #NCT00232934, #ISRCTN 90692740, and #NCT01063179.
AB - Complete response (CR) was an uncommon event in elderly myeloma patients until novel agents were combined with standard oral melphalan-prednisone. This analysis assesses the impact of treatment response on progression-free survival (PFS) and overall survival (OS). We retrospectively analyzed 1175 newly diagnosed myeloma patients, enrolled in 3 multicenter trials, treated with melphalanprednisone alone (n = 332), melphalan-prednisone-thalidomide (n = 332), melphalanprednisone-bortezomib (n = 257), or melphalan-prednisone-bortezomib- thalidomide (n = 254). After a median follow-up of 29 months, the 3-year PFS andOSwere 67% and 27% (hazard ratio = 0.16; P < .001), and 91% and 70% (hazard ratio = 0.15; P < .001) in patients who obtained CR and in those who achieved very good partial response, respectively. Similar results were observed in patients older than 75 years. Multivariate analysis confirmed that the achievement of CR was an independent predictor of longer PFS and OS, regardless of age, International Staging System stage, and treatment. These findings highlight a significant association between the achievement of CR and long-term outcome, and support the use of novel agents to achieve maximal response in elderly patients, including those more than 75 years. This trial was registered at www.clinicaltrials.gov as #NCT00232934, #ISRCTN 90692740, and #NCT01063179.
UR - http://www.scopus.com/inward/record.url?scp=79953078844&partnerID=8YFLogxK
U2 - 10.1182/blood-2010-09-307645
DO - 10.1182/blood-2010-09-307645
M3 - Article
SN - 0006-4971
VL - 117
SP - 3025
EP - 3031
JO - Blood
JF - Blood
IS - 11
ER -