Curing myeloma at last: defining criteria and providing the evidence
Authors
Discussion
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Implication
Longitudinal analysis reveals survival plateaus in multiple myeloma, indicating that aggressive upfront combination therapy can achieve curability.
Key Points
- To determine whether long-term progression-free survival and complete response plateaus provide clinical evidence for the curability of multiple myeloma following upfront combination therapy.
- Analyzed long-term outcomes in 1,202 patients treated across successive Total Therapy protocols: TT1 (n=231; median follow-up 21 years), TT2 (n=668; median follow-up 12 years), and TT3a (n=303; median follow-up 9 years).
- Evaluated Kaplan-Meier survival curves and parametric cure models for progression-free survival (PFS) and complete response (CR) duration, stratified by plasma cell gene expression profiling risk in 627 patients.
- Kaplan-Meier survival curves demonstrated cure plateaus emerging at 5 years in the 14% of patients with high-risk disease compared to 10 years in low-risk disease.
- Parametric modeling showed 10-year PFS and CR estimates rose sequentially from 8.8% and 17.9% in TT1, to 15.5% and 28.2% in the TT2 control arm, 25.1% and 35.6% in the TT2 thalidomide arm, and 32.9% and 48.8% in TT3a.
Cite This Study
Barlogie et al. (2014) studied this question.