Contributions
Abstract: PB1691
Type: Publication Only
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Recently more effective induction chemotherapy regimens have been developed and patients treated with these new regimens are able to achieve higher and deeper responses than those previously treated on older regimens. But there are still discussions about which regimen in the first line of therapy is the priority.
We studied the difference between the median of VCd regimen progression-free survival (PFS) and the PFS of VRd treatment used as initial therapy for MM.
Aims
The primary endpoint was to study the best response to VCd/VRd treatment at the time of early response, as well as PFS of newly diagnosed patients with MM.
Methods
Between 2011 and 2021, we analyzed 98 newly diagnosed patients with MM (males:51, females:47) at 6 Ukrainian centers. 70.4% and 29.5% of patients received VCd and VRd regimens, respectively (p<0.05). The response was evaluated at the end of 3-4 cycles and the end of treatment, as per IMWG criteria. The patients’ characteristics were similar in both groups according to ISS stage (ISS III –VRd: 29%, VCd: 24.4%), and median age (VRd -51.5 y.o; VCd-54.5 y.o).
Results
Both VRd and VCd groups ORR was high, (79.3% and 81.1%, respectively). Patients in both groups achieved similar rates ≥VGPR (44.9% VCd vs 51.7% VRd). CR/sCR rates were superior in the VRd arm; 37.9 % vs 28.9%, p< 0.05.
We compared the median of rapid early response with VCd regimen, taking in consideration a larger percentage of CR achievement in the patient group with Lenalidomide-containing regimen. However, we could not obtain an accurate result as the median of rapid response was similar in both groups: 3.1 months for VRd vs 3.2 months for VCd.
The mean of PFS median was 31.93 months, and the OS median was not reached. The PFS was correlated with therapy response. Patients who achieved ≥VGPR vs MR/progression, (84% vs 20%, p<0.0001), had a significantly longer 5-year PFS.
It is interesting to note that during our patient cohort analysis, we discovered a significant risk mitigation of disease relapse in the near 5 years when using a VRd regimen compared to the VCd one, (5-year PFS 50% vs 35%, log-rank test, p<0.0001). The OS level remains nevertheless the same and does not constitute a statistically important result.
Conclusion
Our data suggest that the response to therapy affects the prediction of clinical outcome in patients with MM. Other than OS or PFS, alternative primary endpoints need to be developed for an adequate future assessment of treatment efficiency using VRd and VCd regimens in order to determine the therapy “leader” in newly diagnosed patients with multiple myeloma.
Keyword(s): Myeloma, Progression, Remission, Survival
Abstract: PB1691
Type: Publication Only
Session title: Myeloma and other monoclonal gammopathies - Clinical
Background
Recently more effective induction chemotherapy regimens have been developed and patients treated with these new regimens are able to achieve higher and deeper responses than those previously treated on older regimens. But there are still discussions about which regimen in the first line of therapy is the priority.
We studied the difference between the median of VCd regimen progression-free survival (PFS) and the PFS of VRd treatment used as initial therapy for MM.
Aims
The primary endpoint was to study the best response to VCd/VRd treatment at the time of early response, as well as PFS of newly diagnosed patients with MM.
Methods
Between 2011 and 2021, we analyzed 98 newly diagnosed patients with MM (males:51, females:47) at 6 Ukrainian centers. 70.4% and 29.5% of patients received VCd and VRd regimens, respectively (p<0.05). The response was evaluated at the end of 3-4 cycles and the end of treatment, as per IMWG criteria. The patients’ characteristics were similar in both groups according to ISS stage (ISS III –VRd: 29%, VCd: 24.4%), and median age (VRd -51.5 y.o; VCd-54.5 y.o).
Results
Both VRd and VCd groups ORR was high, (79.3% and 81.1%, respectively). Patients in both groups achieved similar rates ≥VGPR (44.9% VCd vs 51.7% VRd). CR/sCR rates were superior in the VRd arm; 37.9 % vs 28.9%, p< 0.05.
We compared the median of rapid early response with VCd regimen, taking in consideration a larger percentage of CR achievement in the patient group with Lenalidomide-containing regimen. However, we could not obtain an accurate result as the median of rapid response was similar in both groups: 3.1 months for VRd vs 3.2 months for VCd.
The mean of PFS median was 31.93 months, and the OS median was not reached. The PFS was correlated with therapy response. Patients who achieved ≥VGPR vs MR/progression, (84% vs 20%, p<0.0001), had a significantly longer 5-year PFS.
It is interesting to note that during our patient cohort analysis, we discovered a significant risk mitigation of disease relapse in the near 5 years when using a VRd regimen compared to the VCd one, (5-year PFS 50% vs 35%, log-rank test, p<0.0001). The OS level remains nevertheless the same and does not constitute a statistically important result.
Conclusion
Our data suggest that the response to therapy affects the prediction of clinical outcome in patients with MM. Other than OS or PFS, alternative primary endpoints need to be developed for an adequate future assessment of treatment efficiency using VRd and VCd regimens in order to determine the therapy “leader” in newly diagnosed patients with multiple myeloma.
Keyword(s): Myeloma, Progression, Remission, Survival