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Real-world data on Len/Dex combination at second-line therapy of multiple myeloma: treatment at biochemical relapse is a significant prognostic factor for progression-free survival

We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second...

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Published in:Annals of hematology 2018-09, Vol.97 (9), p.1671-1682
Main Authors: Katodritou, Eirini, Kyrtsonis, Marie-Christine, Delimpasi, Sosana, Kyriakou, Despoina, Symeonidis, Argiris, Spanoudakis, Emmanouil, Vasilopoulos, Georgios, Anagnostopoulos, Achilles, Kioumi, Anna, Zikos, Panagiotis, Aktypi, Anthi, Briasoulis, Evangelos, Megalakaki, Aikaterini, Repousis, Panayiotis, Adamopoulos, Ioannis, Gogos, Dimitrios, Kotsopoulou, Maria, Pappa, Vassiliki, Papadaki, Eleni, Fotiou, Despoina, Nikolaou, Eftychia, Giannopoulou, Evlambia, Hatzimichael, Eleftheria, Giannakoulas, Nikolaos, Douka, Vassiliki, Kokoviadou, Kyriaki, Timotheatou, Despoina, Terpos, Evangelos
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creator Katodritou, Eirini
Kyrtsonis, Marie-Christine
Delimpasi, Sosana
Kyriakou, Despoina
Symeonidis, Argiris
Spanoudakis, Emmanouil
Vasilopoulos, Georgios
Anagnostopoulos, Achilles
Kioumi, Anna
Zikos, Panagiotis
Aktypi, Anthi
Briasoulis, Evangelos
Megalakaki, Aikaterini
Repousis, Panayiotis
Adamopoulos, Ioannis
Gogos, Dimitrios
Kotsopoulou, Maria
Pappa, Vassiliki
Papadaki, Eleni
Fotiou, Despoina
Nikolaou, Eftychia
Giannopoulou, Evlambia
Hatzimichael, Eleftheria
Giannakoulas, Nikolaos
Douka, Vassiliki
Kokoviadou, Kyriaki
Timotheatou, Despoina
Terpos, Evangelos
description We evaluated progression-free survival (PFS) rate of patients treated with lenalidomide/dexamethasone (Len/Dex), the efficacy of the combination, and the prognostic significance of treatment at biochemical vs. clinical relapse on PFS in 207 consecutive myeloma patients treated with Len/Dex in second line, according to routine clinical practice in Greece. First-line treatment included bortezomib-based (63.3%) or immunomodulatory drug-based (34.8%) therapies; 25% of patients underwent autologous stem cell transplantation. Overall response rate was 73.4% (17.8% complete response and 23.7% very good partial response); median time to best response was 6.7 months. Overall, median PFS and 12-month PFS rate was 19.2 months and 67.6%, respectively. 67.5% of patients had biochemical relapse and 32.5% had clinical relapse prior to initiation of Len/Dex. Median PFS was 24 months for patients treated at biochemical relapse vs. 13.2 months for those treated at clinical relapse (HR:0.63, p  = 0.006) and the difference remained significant after adjustment for other prognostic factors. Type of relapse was the strongest prognostic factor for PFS in multivariate analysis. These real-world data confirm the efficacy of Len/Dex combination at first relapse; more importantly, it is demonstrated for the first time outside a clinical trial setting that starting therapy with Len/Dex at biochemical, rather than at clinical relapse, is a significant prognostic factor for PFS, inducing a 37% reduction of the probability of disease progression or death.
doi_str_mv 10.1007/s00277-018-3361-2
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subjects Hematology
Medical prognosis
Medicine
Medicine & Public Health
Multiple myeloma
Multivariate analysis
Oncology
Original
Original Article
Steroids
title Real-world data on Len/Dex combination at second-line therapy of multiple myeloma: treatment at biochemical relapse is a significant prognostic factor for progression-free survival
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-03T11%3A32%3A00IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Real-world%20data%20on%20Len/Dex%20combination%20at%20second-line%20therapy%20of%20multiple%20myeloma:%20treatment%20at%20biochemical%20relapse%20is%20a%20significant%20prognostic%20factor%20for%20progression-free%20survival&rft.jtitle=Annals%20of%20hematology&rft.au=Katodritou,%20Eirini&rft.date=2018-09-01&rft.volume=97&rft.issue=9&rft.spage=1671&rft.epage=1682&rft.pages=1671-1682&rft.issn=0939-5555&rft.eissn=1432-0584&rft_id=info:doi/10.1007/s00277-018-3361-2&rft_dat=%3Cproquest_pubme%3E2038148256%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c536t-21a1a7d1edf8d9dab8ad4b94f2117483de7c3b906a23686fcdef491807c50a7d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2038148256&rft_id=info:pmid/29756171&rfr_iscdi=true