Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
Bahlis, Nizar J (University of Calgary)
Corso, A. (Policlinico San Matteo Universita di Pavia)
Mugge, L.O. (Universitätsklinikum Jena)
Shen, Z.X. (Shanghai Jiao Tong University)
Desjardins, Pierre (Hôpital Charles LeMoyne)
Stoppa, A.M. (Institut Paoli Calmettes)
Decaux, O. (CHRU Hôpital Sud Médecine Interne)
De Revel, T. (Hôpital d'Instruction des Armées PERCY)
Granell, Miquel (Institut d'Investigació Biomèdica Sant Pau)
Marit, G. (CHU de Bordeaux)
Nahi, H. (Karolinska Institutet (Suecia))
Demuynck, H. (H. Hart Ziekenhuis Roeselare-Menen)
Huang, S.Y. (National Taiwan University Hospital (Taipei, Taiwan))
Basu, S. (New Cross Hospital)
Guthrie, T.H. (21st Century Oncology)
Ervin-Haynes, A. (Celgene Corporation)
Marek, J. (Celgene Corporation)
Chen, G. (Celgene Corporation)
Facon, T. (CHRU Lille)
Universitat Autònoma de Barcelona

Date:	2017
Abstract:	The phase 3, randomized Frontline Investigation of Revlimid and Dexamethasone Versus Standard Thalidomide (FIRST) trial investigating lenalidomide plus low-dose dexamethasone until disease progression (Rd continuous) vs melphalan, prednisone and thalidomide for 12 cycles (MPT) and Rd for 18 cycles (Rd18) in transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM) showed that Rd continuous prolonged progression-free survival and overall survival compared with MPT. A subanalysis of the FIRST trial was conducted to determine the benefits of Rd continuous in patients with NDMM based on depth of response. Patients randomized 1:1:1 to Rd continuous, Rd18 or MPT were divided into subgroups based on best response: complete response (CR; n=290), ≥ very good partial response (VGPR; n=679), ≥ partial response (PR; n=1 225) or ≤ stable disease (n=299). Over 13% of patients receiving Rd continuous who achieved ≥ VGPR as best response did so beyond 18 months of treatment. Rd continuous reduced the risk of progression or death by 67%, 51% and 35% vs MPT in patients with CR, ≥ VGPR and ≥ PR, respectively. Similarly, Rd continuous reduced the risk of progression or death by 61%, 54% and 38% vs Rd18 in patients with CR, ≥ VGPR and ≥ PR, respectively. In patients with CR, ≥ VGPR or ≥ PR, 4-year survival rates in the Rd continuous arm (81. 1%, 73. 1% or 64. 6%, respectively) were higher vs MPT (70. 8%, 59. 8% or 57. 2%, respectively) and similar vs Rd18 (76. 5%, 67. 7% and 62. 5%, respectively). Rd continuous improved efficacy outcomes in all responding patients, including those with CR, compared with fixed duration treatment.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Leukemia, Vol. 31 Núm. 11 (january 2017) , p. 2435-2442, ISSN 1476-5551

DOI: 10.1038/leu.2017.111
PMID: 28373701

8 p, 2.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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