Researchers have found that with new treatments for multiple myeloma, a serious type of blood cancer, clinicians will have to use different criteria to identify patients with a low chance of survival. The study is published by Wiley online at CANCERa peer-reviewed journal of the American Cancer Society.
Functional high-risk multiple myeloma (FHR), which affects a subset of blood cancer patients, is usually defined as multiple myeloma that progresses within 18 months of starting treatment and has a survival prognosis of less than 2 years after progression. Recently, however, the use of a 4-part regimen—including anti-CD38 antibodies, proteasome inhibitors, immunomodulatory agents, and dexamethasone followed by autologous stem cell transplantation—helped slow the progression of the cancer.
To update the definition of multiple myeloma FHR in the current era of combination therapy, researchers from the University of Alabama at Birmingham and the CoMMiT consortium analyzed information on 310 patients with newly diagnosed multiple myeloma who received this therapy and were followed for a median of 3.5 years.
Survival analyzes showed that cancer progression within 36 months of starting combination therapy identified patients whose survival was likely to be less than 2 years from the time of progression. Adding another treatment called T-cell redirection therapy helped slow the progression. This “FHR36” patient population, representing 16.4% of all treated patients, should be prioritized as candidates for early use of T-cell redirection therapy and for clinical trials of drugs with new mechanisms of action.
The findings will help physicians select treatments for this significant minority of patients who have disease progression within the first 3 years of diagnosis and identify an important population in greatest need of treatment innovations to be addressed in the next generation of clinical trials.”
Luciano J. Costa, MD, PhD, senior author, University of Alabama at Birmingham
