Prognostic Value of Serum Paraprotein Response Kinetics in Patients With Newly Diagnosed Multiple Myeloma

Tamariz-Amador, Luis-Esteban; Rodríguez-Otero, Paula; Jiménez-Ubieto, Ana; Rosiñol, Laura; Oriol, Albert; Ríos-Tamayo, Rafael; Sureda, Anna; Blanchard, María Jesús; Hernández, Miguel Teodoro; Cabañas Perianes, Valentín; Jarque, Isidro; Bargay, Joan; Gironella, Mercedes; De Arriba, Felipe; Palomera, Luis; González Montes, Yolanda; Martí, José M.; Krsnik, Isabel; Arguiñano, José M.; González, Maríua Ester; Casado Montero, Luis Felipe; González-Rodriguez, Ana Pilar; López-Anglada, Lucía; Puig, Noemí; Cedena, María Teresa; Paiva, Bruno; Mateos, M. V; San-Miguel, J; Lahuerta, J. J; Bladé Creixenti, Juan; Trocóniz, Iñaki F.

doi:10.1016/j.clml.2022.04.024

Cita bibliogràfica -- Enllaç permanent: https://ddd.uab.cat/record/270531

Web of Science: 2 cites, Scopus: 2 cites, Google Scholar: cites,

Prognostic Value of Serum Paraprotein Response Kinetics in Patients With Newly Diagnosed Multiple Myeloma
Tamariz-Amador, Luis-Esteban

(Clínica Universidad de Navarra)
Rodríguez-Otero, Paula (Clínica Universidad de Navarra)
Jiménez-Ubieto, Ana (Hospital Universitario 12 de Octubre (Madrid))
Rosiñol, Laura

(Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Oriol, Albert

(Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Ríos-Tamayo, Rafael

(Hospital Universitario Puerta de Hierro Majadahonda (Madrid)) [...] Mostra tots els 32 autors

Data: 2022

Resum: Introduction: Response kinetics is a well-established prognostic marker in acute lymphoblastic leukemia. The situation is not clear in multiple myeloma (MM) despite having a biomarker for response monitoring (monoclonal component [MC]). Materials and Methods: We developed a mathematical model to assess the prognostic value of serum MC response kinetics during 6 induction cycles, in 373 NDMM transplanted patients treated in the GEM2012Menos65 clinical trial. The model calculated a "resistance" parameter that reflects the stagnation in the response after an initial descent. Results: Two patient subgroups were defined based on low and high resistance, that respectively captured sensitive and refractory kinetics, with progression-free survival (PFS) at 5 years of 72% and 59% (HR 0. 64, 95% CI 0. 44-0. 93; P =. 02). Resistance significantly correlated with depth of response measured after consolidation (80. 9% CR and 68. 4% minimal residual disease negativity in patients with sensitive vs. 31% and 20% in those with refractory kinetics). Furthermore, it modulated the impact of reaching CR after consolidation; thus, within CR patients those with refractory kinetics had significantly shorter PFS than those with sensitive kinetics (median 54 months vs. NR; P =. 02). Minimal residual disease negativity abrogated this effect. Our study also questions the benefit of rapid responders compared to late responders (5-year PFS 59. 7% vs. 76. 5%, respectively [P <. 002]). Of note, 85% of patients considered as late responders were classified as having sensitive kinetics. Conclusion: This semi-mechanistic modeling of M-component kinetics could be of great value to identify patients at risk of early treatment failure, who may benefit from early rescue intervention strategies.

Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.

Llengua: Anglès

Document: Article ; recerca ; Versió publicada

Publicat a: Clinical Lymphoma, Myeloma & Leukemia, Vol. 22 Núm. 9 (september 2022) , p. e844-e852, ISSN 2152-2669

DOI: 10.1016/j.clml.2022.04.024

9 p, 1.1 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Institut de Recerca contra la Leucèmia Josep Carreras
Articles > Articles de recerca
Articles > Articles publicats

Registre creat el 2023-01-17, darrera modificació el 2025-01-27

Registres semblants

Afegeix-lo al cistell personal
Anomena i desa Citation, BibTeX, MARC, MARCXML, DC, EDM OpenAire4

Data:	2022
Resum:	Introduction: Response kinetics is a well-established prognostic marker in acute lymphoblastic leukemia. The situation is not clear in multiple myeloma (MM) despite having a biomarker for response monitoring (monoclonal component [MC]). Materials and Methods: We developed a mathematical model to assess the prognostic value of serum MC response kinetics during 6 induction cycles, in 373 NDMM transplanted patients treated in the GEM2012Menos65 clinical trial. The model calculated a "resistance" parameter that reflects the stagnation in the response after an initial descent. Results: Two patient subgroups were defined based on low and high resistance, that respectively captured sensitive and refractory kinetics, with progression-free survival (PFS) at 5 years of 72% and 59% (HR 0. 64, 95% CI 0. 44-0. 93; P =. 02). Resistance significantly correlated with depth of response measured after consolidation (80. 9% CR and 68. 4% minimal residual disease negativity in patients with sensitive vs. 31% and 20% in those with refractory kinetics). Furthermore, it modulated the impact of reaching CR after consolidation; thus, within CR patients those with refractory kinetics had significantly shorter PFS than those with sensitive kinetics (median 54 months vs. NR; P =. 02). Minimal residual disease negativity abrogated this effect. Our study also questions the benefit of rapid responders compared to late responders (5-year PFS 59. 7% vs. 76. 5%, respectively [P <. 002]). Of note, 85% of patients considered as late responders were classified as having sensitive kinetics. Conclusion: This semi-mechanistic modeling of M-component kinetics could be of great value to identify patients at risk of early treatment failure, who may benefit from early rescue intervention strategies.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Clinical Lymphoma, Myeloma & Leukemia, Vol. 22 Núm. 9 (september 2022) , p. e844-e852, ISSN 2152-2669