Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group study

S. K. Kumar, J. H. Lee, J. J. Lahuerta, G. Morgan, P. G. Richardson, J. Crowley, J. Haessler, J. Feather, A. Hoering, P. Moreau, X. Leleu, C. Hulin, S. K. Klein, P. Sonneveld, D. Siegel, J. Bladé, H. Goldschmidt, S. Jagannath, J. S. Miguel, R. OrlowskiA. Palumbo, O. Sezer, S. V. Rajkumar, B. G.M. Durie

Research output: Contribution to journalArticle

481 Scopus citations

Abstract

Promising new drugs are being evaluated for treatment of multiple myeloma (MM), but their impact should be measured against the expected outcome in patients failing current therapies. However, the natural history of relapsed disease in the current era remains unclear. We studied 286 patients with relapsed MM, who were refractory to bortezomib and were relapsed following, refractory to or ineligible to receive, an IMiD (immunomodulatory drug), had measurable disease, and ECOG PS of 0, 1 or 2. The date patients satisfied the entry criteria was defined as time zero (T0). The median age at diagnosis was 58 years, and time from diagnosis to T0 was 3.3 years. Following T0, 213 (74%) patients had a treatment recorded with one or more regimens (median=1; range 0-8). The first regimen contained bortezomib in 55 (26%) patients and an IMiD in 70 (33%). A minor response or better was seen to at least one therapy after T0 in 94 patients (44%) including ≥partial response in 69 (32%). The median overall survival and event-free survival from T0 were 9 and 5 months, respectively. This study confirms the poor outcome, once patients become refractory to current treatments. The results provide context for interpreting ongoing trials of new drugs.

Original languageEnglish (US)
Pages (from-to)149-157
Number of pages9
JournalLeukemia
Volume26
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • multiple myeloma
  • natural history
  • relapse
  • survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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    Kumar, S. K., Lee, J. H., Lahuerta, J. J., Morgan, G., Richardson, P. G., Crowley, J., Haessler, J., Feather, J., Hoering, A., Moreau, P., Leleu, X., Hulin, C., Klein, S. K., Sonneveld, P., Siegel, D., Bladé, J., Goldschmidt, H., Jagannath, S., Miguel, J. S., ... Durie, B. G. M. (2012). Risk of progression and survival in multiple myeloma relapsing after therapy with IMiDs and bortezomib: A multicenter international myeloma working group study. Leukemia, 26(1), 149-157. https://doi.org/10.1038/leu.2011.196