%0 Journal Article
%A Rodríguez-Otero, Paula
%A Mateos, María Victoria
%A Martínez-López, Joaquín
%A Hernández, Miguel-Teodoro
%A Ocio, Enrique M
%A Rosiñol, Laura
%A Martínez, Rafael
%A Teruel, Ana-Isabel
%A Gutiérrez, Norma C
%A Bargay, Joan
%A Bengoechea, Enrique
%A González, Yolanda
%A de Oteyza, Jaime Pérez
%A Gironella, Mercedes
%A Nuñez-Córdoba, Jorge M
%A Encinas, Cristina
%A Martín, Jesús
%A Cabrera, Carmen
%A Palomera, Luis
%A de Arriba, Felipe
%A Cedena, María Teresa
%A Puig, Noemí
%A Oriol, Albert
%A Paiva, Bruno
%A Bladé, Joan
%A Lahuerta, Juan José
%A San Miguel, Jesús F
%T Predicting long-term disease control in transplant-ineligible patients with multiple myeloma: impact of an MGUS-like signature.
%D 2019
%U http://hdl.handle.net/10668/13730
%X Disease control at 5 years would be a desirable endpoint for elderly multiple myeloma (MM) patients, but biomarkers predicting this are not defined. Therefore, to gain further insights in this endpoint, a population of 498 newly diagnosed transplant-ineligible patients enrolled in two Spanish trials (GEM2005MAS65 and GEM2010MAS65), has been analyzed. Among the 435 patients included in this post-hoc study, 18.6% remained alive and progression free after 5 years of treatment initiation. In these patients, overall survival (OS) rate at 10 years was 60.8% as compared with 11.8% for those progressing within the first 5 years. Hemoglobin (Hb) ≥ 12 g/dl (OR 2.74, p = 0.001) and MGUS-like profile (OR 4.18, p = 0.005) were the two baseline variables associated with long-term disease-free survival. Upon including depth of response (and MRD), Hb ≥ 12 g/dl (OR 2.27) and MGUS-like signature (OR 7.48) retained their predictive value along with MRD negativity (OR 5.18). This study shows that despite the use of novel agents, the probability of disease control at 5 years is still restricted to a small fraction (18.6%) of elderly MM patients. Since this endpoint is associated with higher rates of OS, this study provides important information about diagnostic and post-treatment biomarkers helpful in predicting the likelihood of disease control at 5 years.
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