Clinical Outcome of Induction Treatment in the Era of Novel Agents and the Impact of the Number of High-Risk Cytogenetic Abnormalities (HRA) on Prognosis of Patients With Newly Diagnosed Multiple Myeloma (NDMM): Insights From a Multicenter Study

IF 2.9 2区医学 Q2 ONCOLOGY Cancer Medicine Pub Date : 2024-10-18 DOI:10.1002/cam4.70270

Dong Liang, Xiaojin Li, Shenrui Bai, Qiaoli Wang, Min Zeng, Demei Feng, Bo Lu, Xiaoqing Li, Zhiqiang Sun, Jianyun Li, Huanhuan Zhou, Jialu Zhang, Xiaoqin Chen, Zhongjun Xia, Yang Liang, Hua Wang

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Abstract

Background

In the era of novel agents, the clinical outcomes of induction treatment and the impact of the number of high-risk cytogenetic abnormalities (HRA) in newly diagnosed multiple myeloma (NDMM) need to be explored.

Objective

Through this study, we aim to analyze the effectiveness of different induction treatments and explore the survival outcomes of patients with varying numbers of HRA.

Methods

A total of 734 patients from seven medical centers were included in our study.

Results

Patients in the CD38 monoclonal antibody or IMiDs plus proteasome inhibitors (PI) groups had significantly superior overall survival (OS) and progression-free survival (PFS) compared to those receiving IMiDs or PI alone. Additionally, the CD38 monoclonal antibody conferred a PFS advantage over IMiDs plus PI. Patients with ≥ 2 high-risk cytogenetic abnormalities (HRA) exhibited an extremely poor prognosis and should be considered ultra-high-risk individuals in multiple myeloma (MM). The CD38 monoclonal antibody, transplantation, and achieving minimal residual disease (MRD) negativity only partly mitigated the poor prognosis in patients with HRA. Furthermore, patients with 1q21 gain/amplification (1q21+) only had a significantly worse prognosis compared to patients without HRA, and those with 1q21+ plus del17p or t(4;14) exhibited an inferior prognosis compared to those with 1q21+ alone.

Conclusion

Our results suggested that double-hit multiple myeloma was associated with extremely poor survival outcomes, and more effective treatments needed to be explored for this particular subtype of MM.

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新型药物时代诱导治疗的临床结果以及高危细胞遗传学异常（HRA）数量对新诊断多发性骨髓瘤（NDMM）患者预后的影响：一项多中心研究的启示

背景在新药层出不穷的时代，新诊断多发性骨髓瘤（NDMM）诱导治疗的临床疗效以及高危细胞遗传学异常（HRA）数量的影响亟待探讨。目的通过本研究，我们旨在分析不同诱导治疗的有效性，并探讨不同HRA数量患者的生存结果。方法我们的研究共纳入了来自七个医疗中心的 734 例患者。结果 CD38单克隆抗体或IMiDs加蛋白酶体抑制剂（PI）组患者的总生存期（OS）和无进展生存期（PFS）明显优于单独接受IMiDs或PI治疗的患者。此外，CD38单克隆抗体比IMiDs加PI组的PFS更有优势。高危细胞遗传学异常（HRA）≥2例的患者预后极差，应被视为多发性骨髓瘤（MM）的超高危患者。CD38单克隆抗体、移植和最小残留病（MRD）阴性只能部分缓解HRA患者的不良预后。此外，与无 HRA 的患者相比，仅有 1q21 增益/扩增（1q21+）的患者预后明显较差，而 1q21+ 加上 del17p 或 t(4;14)的患者预后则比仅有 1q21+ 的患者差。结论我们的研究结果表明，双重基因突变的多发性骨髓瘤患者的生存预后极差，因此需要针对这种特殊亚型的多发性骨髓瘤探索更有效的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Medicine ONCOLOGY-

CiteScore

5.50

自引率

2.50%

发文量

907

审稿时长

19 weeks

期刊介绍： Cancer Medicine is a peer-reviewed, open access, interdisciplinary journal providing rapid publication of research from global biomedical researchers across the cancer sciences. The journal will consider submissions from all oncologic specialties, including, but not limited to, the following areas: Clinical Cancer Research Translational research ∙ clinical trials ∙ chemotherapy ∙ radiation therapy ∙ surgical therapy ∙ clinical observations ∙ clinical guidelines ∙ genetic consultation ∙ ethical considerations Cancer Biology: Molecular biology ∙ cellular biology ∙ molecular genetics ∙ genomics ∙ immunology ∙ epigenetics ∙ metabolic studies ∙ proteomics ∙ cytopathology ∙ carcinogenesis ∙ drug discovery and delivery. Cancer Prevention: Behavioral science ∙ psychosocial studies ∙ screening ∙ nutrition ∙ epidemiology and prevention ∙ community outreach. Bioinformatics: Gene expressions profiles ∙ gene regulation networks ∙ genome bioinformatics ∙ pathwayanalysis ∙ prognostic biomarkers. Cancer Medicine publishes original research articles, systematic reviews, meta-analyses, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented in the paper.