Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
Por:
Bahlis, NJ, Corso, A, Mugge, LO, Shen, ZX, Desjardins, P, Stoppa, AM, Decaux, O, de Revel, T, Granell, M, Marit, G, Nahi, H, Demuynck, H, Huang, SY, Basu, S, Guthrie, TH, Ervin-Haynes, A, Marek, J, Chen, G, Facon, T
Publicada:
1 nov 2017
Resumen:
The phase 3, randomized Frontline Investigation of Revlimid and Dexamethasone Versus Standard Thalidomide (FIRST) trial investigating lenalidomide plus low-dose dexamethasone until disease progression (Rd continuous) vs melphalan, prednisone and thalidomide for 12 cycles (MPT) and Rd for 18 cycles (Rd18) in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM) showed that Rd continuous prolonged progression-free survival and overall survival compared with MPT. A subanalysis of the FIRST trial was conducted to determine the benefits of Rd continuous in patients with NDMM based on depth of response. Patients randomized 1:1:1 to Rd continuous, Rd18 or MPT were divided into subgroups based on best response: complete response (CR; n = 290), >= very good partial response (VGPR; n = 679), >= partial response (PR; n = 1 225) or >= stable disease (n = 299). Over 13% of patients receiving Rd continuous who achieved. VGPR as best response did so beyond 18 months of treatment. Rd continuous reduced the risk of progression or death by 67%, 51% and 35% vs MPT in patients with CR, >= VGPR and. PR, respectively. Similarly, Rd continuous reduced the risk of progression or death by 61%, 54% and 38% vs Rd18 in patients with CR, >= VGPR and. PR, respectively. In patients with CR, >= VGPR or >= PR, 4-year survival rates in the Rd continuous arm (81.1%, 73.1% or 64.6%, respectively) were higher vs MPT (70.8%, 59.8% or 57.2%, respectively) and similar vs Rd18 (76.5%, 67.7% and 62.5%, respectively). Rd continuous improved efficacy outcomes in all responding patients, including those with CR, compared with fixed duration treatment.
Filiaciones:
Bahlis, NJ:
Univ Calgary, Tom Baker Canc Ctr, Calgary, AB, Canada
Corso, A:
Univ Pavia, Policlin San Matteo, Pavia, Italy
Mugge, LO:
Univ Klinikum Jena, Klin Innere Med 2, Jena, Germany
Shen, ZX:
Shanghai Jiao Tong Univ, Ruijin Hosp, Shanghai, Peoples R China
Desjardins, P:
Hop Charles LeMoyne, Longueuil, PQ, Canada
Stoppa, AM:
Inst Paoli Calmettes, Marseille, France
Decaux, O:
CHRU, Hop Sud Med Interne, Rennes, France
de Revel, T:
Hop Instruct Armees PERCY, Paris, France
Granell, M:
Hosp Santa Creu & Sant Pau, Barcelona, Spain
Marit, G:
CHU Bordeaux, CHRU, Hop Haut Leveque, Pessac, France
Nahi, H:
Karolinska Univ Hosp, Huddinge, Sweden
Demuynck, H:
H Hart Ziekenhuis Roeselare Menen, Roeselare, Belgium
Huang, SY:
Natl Taiwan Univ Hosp, Taipei, Taiwan
Basu, S:
New Cross Hosp, Wolverhampton, W Midlands, England
Guthrie, TH:
21st Century Oncol, Jacksonville, FL USA
Ervin-Haynes, A:
Celgene Corp, Summit, NJ USA
Marek, J:
Celgene Corp, Summit, NJ USA
Chen, G:
Celgene Corp, Summit, NJ USA
Facon, T:
CHRU Lille, Serv Malad Sang, Hop Claude Huriez, Lille, France
Green Published, Hybrid Gold
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