title: The impact of response on bone-directed therapy in patients with multiple myeloma.
abstract: Significant benefits for zoledronic acid (ZOL) over clodronate acid (CLO) were seen in the Medical Research Council Myeloma IX randomized trial. ZOL significantly reduced skeletal-related events (SREs), and improved progression-free survival and overall survival (OS), making it the bisphosphonate of choice for newly diagnosed myeloma patients. In this analysis of Myeloma IX data, we have investigated the impact of response on bone disease in 1111 transplant-eligible patients. At posttransplant day 100, complete response (CR) was seen in 48% of patients, very good partial response (VGPR) in 20%, and partial response (PR) in 23%. For patients in VGPR or less, ZOL was superior to CLO in reducing SREs (P = .048), whereas for patients in CR, both agents were equivalent (P = .83). For OS, ZOL was associated with a significant benefit in patients in PR (P = .0091). No difference in OS was seen with patients in CR (P = .91) or VGPR (P = .74). These findings indicate that response category posttransplant may influence the impact of bisphosphonate therapy.
authors: Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy;
authors: Alessandra
authors: A
authors: Larocca
authors: J Anthony
authors: JA
authors: Child
authors: Gordon
authors: G
authors: Cook
authors: Graham H
authors: GH
authors: Jackson
authors: Nigel
authors: N
authors: Russell
authors: Alexander
authors: A
authors: Szubert
authors: Walter M
authors: WM
authors: Gregory
authors: Annamaria
authors: A
authors: Brioli
authors: Roger G
authors: RG
authors: Owen
authors: Mark T
authors: MT
authors: Drayson
authors: Ping
authors: P
authors: Wu
authors: Antonio
authors: A
authors: Palumbo
authors: Mario
authors: M
authors: Boccadoro
authors: Faith E
authors: FE
authors: Davies
authors: Gareth J
authors: GJ
authors: Morgan
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D001842:Bone and Bones / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D004002:Clodronic Acid / Q000627:therapeutic use; D004164:Diphosphonates / Q000627:therapeutic use*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D000077211:Zoledronic Acid
chemical_list: D000970:Antineoplastic Agents; D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D004002:Clodronic Acid; D000077211:Zoledronic Acid