Literature Scan
In the entire cohort, the following
baseline characteristics were associated
with an increased odds of achieving
VGPR+ within four treatment cycles:
• Greater absolute free light chain
(FLC) differences (odds ratio [OR]
= 2.38; 95% CI 1.48-3.82)
• Patients younger in age (OR=2.18;
95% CI, 1.28-3.71)
• Lower hemoglobin levels
(OR=1.68; 95% CI 1.12-2.54)
• IgA myeloma (OR=1.66; 95% CI
1.10-2.51)
“Both disease and patient factors were
associated with better response early on,”
Dr. Binder told ASH Clinical News, “and
these factors were different for regimens
containing immunomodulators and proteasome inhibitors.” In patients receiving
proteasome inhibitors, the following
parameters were associated with a better
treatment response:
• Higher creatinine (OR=3.83; 95%
CI 1.37-10.1)
• Lower calcium (OR=3.37; 95% CI
1.35-8.35)
• Greater absolute FLC differences
(OR=2.50; 95% CI 1.10-5.71)
“Patients with better responses early in
their course of treatment experienced
longer overall survival,” Dr. Binder added. In a landmark analysis at four months
from diagnosis, achieving VGPR+ was
associated with decreased risk of subsequent mortality (hazard ratio = 0.69; 95%
CI 0.53-0.86).
“This study was a first step in
identifying factors that determine early
response to treatment in patients with
newly diagnosed disease,” Dr. Binder
said. “These results will help to improve
our understanding of the underlying
complex disease biology that makes the
treatment of multiple myeloma an ongoing challenge.”
Dr. Binder noted one limitation of the
study: its retrospective design. “While
these findings are intriguing, the suitability of these biomarkers needs to be
evaluated in prospective studies before
drawing firm conclusions and making
definitive treatment recommendations,”
he said. “Eventually, an individualized
appr