TY - JOUR
T1 - Maintenance in myeloma patients achieving complete response after upfront therapy
T2 - a pooled analysis
AU - Cerrato, Chiara
AU - Di Raimondo, Francesco
AU - De Paoli, Lorenzo
AU - Spada, Stefano
AU - Patriarca, Francesca
AU - Crippa, Claudia
AU - Mina, Roberto
AU - Guglielmelli, Tommasina
AU - Ben-Yehuda, Dina
AU - Oddolo, Daniela
AU - Nozzoli, Chiara
AU - Angelucci, Emanuele
AU - Cascavilla, Nicola
AU - Rizzi, Rita
AU - Rocco, Stefano
AU - Baldini, Luca
AU - Ponticelli, Elena
AU - Marcatti, Magda
AU - Cangialosi, Clotilde
AU - Caravita, Tommaso
AU - Benevolo, Giulia
AU - Ria, Roberto
AU - Nagler, Arnon
AU - Musto, Pellegrino
AU - Tacchetti, Paola
AU - Corradini, Paolo
AU - Offidani, Massimo
AU - Palumbo, Antonio
AU - Petrucci, Maria Teresa
AU - Boccadoro, Mario
AU - Gay, Francesca
N1 - Publisher Copyright:
© 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Purpose: Maintenance demonstrated to improve survival in newly diagnosed multiple myeloma (NDMM) patients and the achievement of complete response (CR) is a strong predictor of survival. Nevertheless, the role of maintenance according to response after induction/consolidation has not been investigated so far. To evaluate the impact of maintenance according to response, we pooled together and retrospectively analyzed data from 955 NDMM patients enrolled in two trials (GIMEMA-MM-03-05 and RV-MM-PI-209). Methods: Primary endpoints were progression-free survival (PFS)1, PFS2 and overall survival (OS) of CR patients randomized to maintenance and no maintenance. Secondary endpoints were PFS1, PFS2 and OS in very good partial response/partial response (VGPR/PR) patients. Results: Overall, 213 patients obtained CR after induction/consolidation, 118 received maintenance and 95 no maintenance. In patients achieving CR, maintenance significantly improved PFS1 (HR 0.50, P < 0.001), PFS2 (HR 0.58, P 0.02) and OS (HR 0.51, P 0.02) compared with no maintenance; the advantage was maintained across all the analyzed subgroups according to age, International Staging System (ISS) stage, cytogenetic profile and treatment. Similar features were seen in VGPR/PR patients. Conclusion: Maintenance prolonged survival in CR and in VGPR/PR patients. The benefit in CR patients suggests the importance of continuing treatment in patients with chemo-sensitive disease. Trial registration: The two source studies are registered at ClinicalTrials.gov: identification numbers NCT01063179 and NCT00551928.
AB - Purpose: Maintenance demonstrated to improve survival in newly diagnosed multiple myeloma (NDMM) patients and the achievement of complete response (CR) is a strong predictor of survival. Nevertheless, the role of maintenance according to response after induction/consolidation has not been investigated so far. To evaluate the impact of maintenance according to response, we pooled together and retrospectively analyzed data from 955 NDMM patients enrolled in two trials (GIMEMA-MM-03-05 and RV-MM-PI-209). Methods: Primary endpoints were progression-free survival (PFS)1, PFS2 and overall survival (OS) of CR patients randomized to maintenance and no maintenance. Secondary endpoints were PFS1, PFS2 and OS in very good partial response/partial response (VGPR/PR) patients. Results: Overall, 213 patients obtained CR after induction/consolidation, 118 received maintenance and 95 no maintenance. In patients achieving CR, maintenance significantly improved PFS1 (HR 0.50, P < 0.001), PFS2 (HR 0.58, P 0.02) and OS (HR 0.51, P 0.02) compared with no maintenance; the advantage was maintained across all the analyzed subgroups according to age, International Staging System (ISS) stage, cytogenetic profile and treatment. Similar features were seen in VGPR/PR patients. Conclusion: Maintenance prolonged survival in CR and in VGPR/PR patients. The benefit in CR patients suggests the importance of continuing treatment in patients with chemo-sensitive disease. Trial registration: The two source studies are registered at ClinicalTrials.gov: identification numbers NCT01063179 and NCT00551928.
KW - Complete response (CR)
KW - Maintenance therapy
KW - Multiple myeloma (MM)
KW - Newly diagnosed
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85045751550&partnerID=8YFLogxK
U2 - 10.1007/s00432-018-2641-5
DO - 10.1007/s00432-018-2641-5
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 29675792
AN - SCOPUS:85045751550
SN - 0171-5216
VL - 144
SP - 1357
EP - 1366
JO - Journal of Cancer Research and Clinical Oncology
JF - Journal of Cancer Research and Clinical Oncology
IS - 7
ER -
