Helgi van de Velde1, Anil Londhe2, Ozlem Ataman3, Helen L Johns4, Stephen Hill4, Emma Landers4, Jesse A Berlin5. 1. Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA. 2. Janssen Research and Development, Horsham, PA, USA. 3. Janssen Research & Development, High Wycombe, UK. 4. FireKite, an Ashfield Company, part of UDG Healthcare plc, Maidenhead, UK. 5. Johnson & Johnson, Titusville, NJ, USA.
Abstract
OBJECTIVES: Achieving complete response (CR) has been linked to improved progression-free (PFS) and overall (OS) survival in myeloma. A meta-analysis was conducted to investigate whether this holds true in the era of novel agents (bortezomib, lenalidomide, thalidomide). METHODS: A total of 24 studies in newly diagnosed patients undergoing autologous stem cell transplantation (ASCT) that reported associations between responses and long-term outcomes (PFS/OS rates post-ASCT by response, or hazard ratios with 95% confidence intervals from Cox models) were identified and analyzed. RESULTS: Achievement of CR vs. <CR post-ASCT reduced risk of progression/death by 38% [risk ratio (RR): 0.62, P < 0.0001]; risk of death was 41% lower (RR: 0.59, P < 0.0001). Subgroup meta-analyses showed significant PFS risk reduction with CR post-ASCT with novel (RR: 0.32, P < 0.006) and non-novel (RR: 0.72, P < 0.0001) agents, and corresponding OS risk reduction with novel (RR: 0.33, P = 0.0013) and non-novel (RR: 0.64, P < 0.0001) agents. Risk reduction was greater with novel vs. non-novel agents (PFS: P = 0.047; OS: P = 0.058). CONCLUSIONS: Achieving CR during first-line therapy remains important in the novel-agent era; magnitude of association between achieving CR and outcomes appears higher for CR obtained using novel vs. non-novel agents.
OBJECTIVES: Achieving complete response (CR) has been linked to improved progression-free (PFS) and overall (OS) survival in myeloma. A meta-analysis was conducted to investigate whether this holds true in the era of novel agents (bortezomib, lenalidomide, thalidomide). METHODS: A total of 24 studies in newly diagnosed patients undergoing autologous stem cell transplantation (ASCT) that reported associations between responses and long-term outcomes (PFS/OS rates post-ASCT by response, or hazard ratios with 95% confidence intervals from Cox models) were identified and analyzed. RESULTS: Achievement of CR vs. <CR post-ASCT reduced risk of progression/death by 38% [risk ratio (RR): 0.62, P < 0.0001]; risk of death was 41% lower (RR: 0.59, P < 0.0001). Subgroup meta-analyses showed significant PFS risk reduction with CR post-ASCT with novel (RR: 0.32, P < 0.006) and non-novel (RR: 0.72, P < 0.0001) agents, and corresponding OS risk reduction with novel (RR: 0.33, P = 0.0013) and non-novel (RR: 0.64, P < 0.0001) agents. Risk reduction was greater with novel vs. non-novel agents (PFS: P = 0.047; OS: P = 0.058). CONCLUSIONS: Achieving CR during first-line therapy remains important in the novel-agent era; magnitude of association between achieving CR and outcomes appears higher for CR obtained using novel vs. non-novel agents.
Authors: Nidhi Tandon; Surbhi Sidana; S Vincent Rajkumar; Morie A Gertz; Francis K Buadi; Martha Q Lacy; Prashant Kapoor; Wilson I Gonsalves; Angela Dispenzieri; Taxiarchis V Kourelis; Rahma Warsame; David Dingli; Amie L Fonder; Suzanne R Hayman; Miriam A Hobbs; Yi Lisa Hwa; Robert A Kyle; Nelson Leung; Ronald S Go; John A Lust; Stephen J Russell; Shaji K Kumar Journal: Blood Adv Date: 2019-03-12
Authors: Juan José Lahuerta; Bruno Paiva; Ana Jiménez-Ubieto; José Sánchez-Pina; María-Victoria Mateos; Joan Bladé; Jesús F San-Miguel Journal: Blood Adv Date: 2021-03-09