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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 |
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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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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.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-018-3361-2</identifier><identifier>PMID: 29756171</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Hematology ; Medical prognosis ; Medicine ; Medicine & Public Health ; Multiple myeloma ; Multivariate analysis ; Oncology ; Original ; Original Article ; Steroids</subject><ispartof>Annals of hematology, 2018-09, Vol.97 (9), p.1671-1682</ispartof><rights>The Author(s) 2018. corrected publication July/2018</rights><rights>Annals of Hematology is a copyright of Springer, (2018). All Rights Reserved. © 2018. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Author(s) 2018, corrected publication July/2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-21a1a7d1edf8d9dab8ad4b94f2117483de7c3b906a23686fcdef491807c50a7d3</citedby><cites>FETCH-LOGICAL-c536t-21a1a7d1edf8d9dab8ad4b94f2117483de7c3b906a23686fcdef491807c50a7d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29756171$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Katodritou, Eirini</creatorcontrib><creatorcontrib>Kyrtsonis, Marie-Christine</creatorcontrib><creatorcontrib>Delimpasi, Sosana</creatorcontrib><creatorcontrib>Kyriakou, Despoina</creatorcontrib><creatorcontrib>Symeonidis, Argiris</creatorcontrib><creatorcontrib>Spanoudakis, Emmanouil</creatorcontrib><creatorcontrib>Vasilopoulos, Georgios</creatorcontrib><creatorcontrib>Anagnostopoulos, Achilles</creatorcontrib><creatorcontrib>Kioumi, Anna</creatorcontrib><creatorcontrib>Zikos, Panagiotis</creatorcontrib><creatorcontrib>Aktypi, Anthi</creatorcontrib><creatorcontrib>Briasoulis, Evangelos</creatorcontrib><creatorcontrib>Megalakaki, Aikaterini</creatorcontrib><creatorcontrib>Repousis, Panayiotis</creatorcontrib><creatorcontrib>Adamopoulos, Ioannis</creatorcontrib><creatorcontrib>Gogos, Dimitrios</creatorcontrib><creatorcontrib>Kotsopoulou, Maria</creatorcontrib><creatorcontrib>Pappa, Vassiliki</creatorcontrib><creatorcontrib>Papadaki, Eleni</creatorcontrib><creatorcontrib>Fotiou, Despoina</creatorcontrib><creatorcontrib>Nikolaou, Eftychia</creatorcontrib><creatorcontrib>Giannopoulou, Evlambia</creatorcontrib><creatorcontrib>Hatzimichael, Eleftheria</creatorcontrib><creatorcontrib>Giannakoulas, Nikolaos</creatorcontrib><creatorcontrib>Douka, Vassiliki</creatorcontrib><creatorcontrib>Kokoviadou, Kyriaki</creatorcontrib><creatorcontrib>Timotheatou, Despoina</creatorcontrib><creatorcontrib>Terpos, Evangelos</creatorcontrib><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</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><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.</description><subject>Hematology</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Multiple myeloma</subject><subject>Multivariate analysis</subject><subject>Oncology</subject><subject>Original</subject><subject>Original 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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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-21a1a7d1edf8d9dab8ad4b94f2117483de7c3b906a23686fcdef491807c50a7d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Hematology</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Multiple myeloma</topic><topic>Multivariate analysis</topic><topic>Oncology</topic><topic>Original</topic><topic>Original 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Evlambia</au><au>Hatzimichael, Eleftheria</au><au>Giannakoulas, Nikolaos</au><au>Douka, Vassiliki</au><au>Kokoviadou, Kyriaki</au><au>Timotheatou, Despoina</au><au>Terpos, Evangelos</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>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</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><addtitle>Ann Hematol</addtitle><date>2018-09-01</date><risdate>2018</risdate><volume>97</volume><issue>9</issue><spage>1671</spage><epage>1682</epage><pages>1671-1682</pages><issn>0939-5555</issn><eissn>1432-0584</eissn><abstract>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.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>29756171</pmid><doi>10.1007/s00277-018-3361-2</doi><tpages>12</tpages><oa>free_for_read</oa></addata></record> |
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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 |