title: Complete response correlates with long-term progression-free and overall survival in elderly myeloma treated with novel agents: analysis of 1175 patients.
abstract: Complete response (CR) was an uncommon event in elderly myeloma patients until novel agents were combined with standard oral melphalan-prednisone. This analysis assesses the impact of treatment response on progression-free survival (PFS) and overall survival (OS). We retrospectively analyzed 1175 newly diagnosed myeloma patients, enrolled in 3 multicenter trials, treated with melphalan-prednisone alone (n = 332), melphalan-prednisone-thalidomide (n = 332), melphalan-prednisone-bortezomib (n = 257), or melphalan-prednisone-bortezomib-thalidomide (n = 254). After a median follow-up of 29 months, the 3-year PFS and OS were 67% and 27% (hazard ratio = 0.16; P < .001), and 91% and 70% (hazard ratio = 0.15; P < .001) in patients who obtained CR and in those who achieved very good partial response, respectively. Similar results were observed in patients older than 75 years. Multivariate analysis confirmed that the achievement of CR was an independent predictor of longer PFS and OS, regardless of age, International Staging System stage, and treatment. These findings highlight a significant association between the achievement of CR and long-term outcome, and support the use of novel agents to achieve maximal response in elderly patients, including those more than 75 years. This trial was registered at www.clinicaltrials.gov as #NCT00232934, #ISRCTN 90692740, and #NCT01063179.
authors.affiliation: Myeloma Unit, Division of Hematology, University of Torino, AOU S. Giovanni Battista, Torino, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gay
authors.forename: Alessandra
authors.initials: A
authors.lastname: Larocca
authors.forename: Pierre
authors.initials: P
authors.lastname: Wijermans
authors.forename: Federica
authors.initials: F
authors.lastname: Cavallo
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.forename: Ron
authors.initials: R
authors.lastname: Schaafsma
authors.forename: Mariella
authors.initials: M
authors.lastname: Genuardi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Romano
authors.forename: Anna Marina
authors.initials: AM
authors.lastname: Liberati
authors.forename: Agostina
authors.initials: A
authors.lastname: Siniscalchi
authors.forename: Maria T
authors.initials: MT
authors.lastname: Petrucci
authors.forename: Chiara
authors.initials: C
authors.lastname: Nozzoli
authors.forename: Francesca
authors.initials: F
authors.lastname: Patriarca
authors.forename: Massimo
authors.initials: M
authors.lastname: Offidani
authors.forename: Roberto
authors.initials: R
authors.lastname: Ria
authors.forename: Paola
authors.initials: P
authors.lastname: Omedè
authors.forename: Benedetto
authors.initials: B
authors.lastname: Bruno
authors.forename: Roberto
authors.initials: R
authors.lastname: Passera
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Mario
authors.initials: M
authors.lastname: Boccadoro
authors.forename: Pieter
authors.initials: P
authors.lastname: Sonneveld
authors.forename: Antonio
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003710:Demography; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009101:Multiple Myeloma / Q000188:drug therapy*; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents