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Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature

Autores: Rodríguez Otero, Paula; Mateos, M. V. ; Martinez-Lopez, J.; Hernandez, M. T.; Ocio, E. M.; Rosinol, L. ; Martinez, R.; Teruel, A. I.; Gutierrez, N. C.; Bargay, J.; Bengoechea, E.; Gonzalez, Y.; de Oteyza, J. P.; Gironella, M.; Núñez Córdoba, Jorge María; Encinas, C.; Martin, J.; Cabrera, C.; Palomera, L.; de Arriba, F.; Cedena, M. T. ; Puig, N.; Oriol, A.; Paiva, Bruno; Blade, J.; Lahuerta, J.J. ; San Miguel Izquierdo, Jesús (Autor de correspondencia)
Título de la revista: BLOOD CANCER JOURNAL
ISSN: 2044-5385
Volumen: 9
Número: 4
Páginas: 36
Fecha de publicación: 2019
Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) >= 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb >= 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years.