Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: Analysis of 1175 patients

Francesca Gay, Alessandra Larocca, Pierre Wijermans, Federica Cavallo, Davide Rossi, Ron Schaafsma, Mariella Genuardi, Alessandra Romano, Anna Marina Liberati, Agostina Siniscalchi, Maria T. Petrucci, Chiara Nozzoli, Francesca Patriarca, Massimo Offidani, Roberto Ria, Paola Omedè, Benedetto Bruno, Roberto Passera, Pellegrino Musto, Mario BoccadoroPieter Sonneveld, Antonio Palumbo

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)3025-3031
Number of pages7
JournalBlood
Volume117
Issue number11
DOIs
Publication statusPublished - Mar 17 2011

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

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