Plateau is a prognostic factor of lenalidomide therapy for previously treated multiple myeloma

Abstract

The plateau phase emerging during the treatment of multiple myeloma (MM) is known to last steadily for a certain period, even without treatment. Therefore, the treatment started at plateau phase is expected to be associated with a better outcome. In this study, this hypothesis was evaluated retrospectively for previously treated MM patients in Kansai Myeloma Forum database who received lenalidomide (LEN) with or without dexamethasone for the first time. Disease stability index (DSI) was defined as (maximum – minimum values of M protein during the 90 days before the start of LEN) divided by M‐protein values at the start of LEN. The patients were classified into three groups: stable (S), DSI ≤ 0.25; increasing (I), DSI > 0.25 with increasing M protein; decreasing (D), DSI > 0.25 with decreasing M protein. In univariate analysis of 352 patients, DSI group "I", non‐IgG type, serum albumin<3.5 g/dL, and age≥70 were statistically significant prognostic factors for both progression‐free survival and overall survival. In multivariate analysis, the former 3 risk factors were statistically significant for poor overall survival. Thus, DSI is an independent prognostic factor for the treatment with LEN for previously treated MM.

Ixazomib‐based maintenance therapy after bortezomib‐based induction in patients with multiple myeloma not undergoing transplantation: A real‐world study

“…Responses were assessed at the end of induction therapy, and every two cycles during maintenance therapy until PD. Plateau phase was defined as stable serum and urine M‐protein values (within 25% above or below the value at the time the response was assessed) maintaining for at least 3 months with SD or better response; without symptoms of myeloma or blood transfusion 17 …”

“…Plateau phase was defined as stable serum and urine M-protein values (within 25% above or below the value at the time the response was assessed) maintaining for at least 3 months with SD or better response; without symptoms of myeloma or blood transfusion. 17 In either NDMM or RRMM group, PFS of total PI therapy (PFS (total PI)) was measured from the time of patients receiving bortezomib, and PFS of ixazomib (PFS (Ixa)) was defined as the initiation of ixazomib, and both of them were cut off on the date of PD or death due to any cause.…”

“…Abbreviations: ISS, International Staging System; LDH, lactate dehydrogenase; NDMM, newly diagnosed multiple myeloma; RRMM, refractory/relapsed multiple myeloma. a High-risk cytogenetics weas defined as any of del(17), gain(1q21), t(4;14) and t(14;16).b No responses deepened included patients of responses maintained and responses progressed. *small…”