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Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
Bahlis, Nizar Corso, A Mugge, LO Shen, ZX Desjardins, P Stoppa, AM Decaux, O De Revel, T Granell, M Marit, G
Bahlis, Nizar
Corso, A
Mugge, LO
Shen, ZX
Desjardins, P
Stoppa, AM
Decaux, O
De Revel, T
Granell, M
Marit, G
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2017-11-01
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Abstract
© 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved. 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.
Citation
Bahlis, N. J., Corso, A., Mugge, L.-O., Shen, Z.-X. et al (2017) Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial, Leukemia, 31, pp. 2435–2442. DOI: 10.1038/leu.2017.111
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28373701 (pubmed)
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Journal article
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en
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© 2017 The Authors. Published by Nature Publishing Group. This is an open access article available under a Creative Commons licence.
The published version can be accessed at the following link on the publisher’s website: https://doi.org/10.1038/leu.2017.111
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0887-6924
EISSN
1476-5551
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Licence for published version: Creative Commons Attribution 4.0 International