PMID- 37152063
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230509
IS  - 2234-943X (Print)
IS  - 2234-943X (Electronic)
IS  - 2234-943X (Linking)
VI  - 13
DP  - 2023
TI  - Lenalidomide or bortezomib as maintenance treatment remedy the inferior impact of 
      high-risk cytogenetic abnormalities in non-transplant patients with newly 
      diagnosed multiple myeloma: a real-world multi-centered study in China.
PG  - 1028571
LID - 10.3389/fonc.2023.1028571 [doi]
LID - 1028571
AB  - Maintenance treatment is a pivotal part in the whole process management of 
      multiple myeloma (MM), which further deepens response and improves survival. 
      However, evidence of maintenance in non-transplant MM patients is inadequate in 
      real-world practice. Here, we retrospectively analyzed the efficacy and survival 
      of 375 non-transplant MM patients from 11 centers between 2010 and 2021 in north 
      China. After a median of seven cycles of front-line regimens, there were 141, 79, 
      and 155 patients receiving lenalidomide maintenance (L-MT), bortezomib 
      maintenance (B-MT), or thalidomide maintenance (T-MT), respectively. Patients on 
      L-MT and B-MT had significantly greater proportions of high-risk cytogenetic 
      abnormalities (HRCAs) detected by fluorescence in situ hybridization (FISH), 
      which was defined as 1q21 gain, 17p deletion, adverse immunoglobulin heavy chain 
      (IgH) translocations. Although the progression-free survival (PFS) and overall 
      survival (OS) were comparable among the three groups, L-MT and B-MT remedied the 
      negative impact of HRCAs on survival (PFS of patients with HRCAs vs. patients 
      without HRCAs: L-MT, 26.9 vs. 39.2 months, p=0.19; B-MT, 20.0 vs. 29.7 months, 
      p=0.36; OS not reached in all groups). Patients with HRCAs in the T-MT group 
      presented inferior clinical outcomes compared to standard-risk patients (PFS, 
      12.1 vs. 22.8 months, p=0.02, HR=1.8, 95% CI 1.0-3.4; OS, 54.9 months vs. NR, 
      p<0.001, HR=3.2, 95% CI 1.5-7.0). Achieving complete response (CR) after 
      induction therapy led to superior PFS compared to other degrees of response, 
      regardless of maintenance medication. Furthermore, maintenance duration over 24 
      months correlated with favorable survival. Due to the large gap of transplant 
      eligibility in China, optimizing maintenance therapy is important for 
      non-transplant MM patients. In this real-world multi-centered study, our findings 
      suggest that clinicians prefer to prescribe lenalidomide or bortezomib as 
      maintenance therapy in high-risk settings, which are superior to thalidomide in 
      non-transplant MM patients. Achievement of CR and maintenance duration over 2 
      years are positive factors that influence survival.
CI  - Copyright (c) 2023 Zhuang, Tian, Shi, Zou, Feng, Tian, Yu, Dong, Liao, Ma, Liu, 
      Liu, Jing, Fu, Ma, Liu, Sun, Bao, Wu, Chen and Zhuang.
FAU - Zhuang, Zhe
AU  - Zhuang Z
AD  - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences, Beijing, China.
FAU - Tian, Ying
AU  - Tian Y
AD  - Department of Hematology, Beijing Chao-Yang Hospital Capital Medical University, 
      Beijing, China.
FAU - Shi, Lei
AU  - Shi L
AD  - Department of Hematology, Beijing University, Beijing Jishuitan Hospital, 
      Beijing, China.
FAU - Zou, Dongmei
AU  - Zou D
AD  - Department of Hematology, Xuanwu Hospital Capital Medical University, Beijing, 
      China.
FAU - Feng, Ru
AU  - Feng R
AD  - Department of Hematology, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 
      China.
FAU - Tian, Wei-Wei
AU  - Tian WW
AD  - Department of Hematology, Shanxi Bethune Hospital of Shanxi Medical University, 
      Taiyuan, China.
FAU - Yu, Hong
AU  - Yu H
AD  - Department of Hematology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Dong, Fei
AU  - Dong F
AD  - Department of Hematology, Peking University Third Hospital, Beijing, China.
FAU - Liao, Aijun
AU  - Liao A
AD  - Department of Hematology, Shengjing Hospital of China Medical University, 
      Shenyang, China.
FAU - Ma, Yanping
AU  - Ma Y
AD  - Department of Hematology, The Second Hospital of Shanxi Medical University, 
      Taiyuan, China.
FAU - Liu, Qinhua
AU  - Liu Q
AD  - Department of Hematology, First Affiliated Hospital of Anhui Medical University, 
      Hefei, China.
FAU - Liu, Shuangjiao
AU  - Liu S
AD  - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences, Beijing, China.
FAU - Jing, Hongmei
AU  - Jing H
AD  - Department of Hematology, Peking University Third Hospital, Beijing, China.
FAU - Fu, Rong
AU  - Fu R
AD  - Department of Hematology, Tianjin Medical University General Hospital, Tianjin, 
      China.
FAU - Ma, Liang-Ming
AU  - Ma LM
AD  - Department of Hematology, Shanxi Bethune Hospital of Shanxi Medical University, 
      Taiyuan, China.
FAU - Liu, Hui
AU  - Liu H
AD  - Department of Hematology, Beijing Hospital, National Center of Gerontology, 
      Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing, 
      China.
FAU - Sun, Wanling
AU  - Sun W
AD  - Department of Hematology, Xuanwu Hospital Capital Medical University, Beijing, 
      China.
FAU - Bao, Li
AU  - Bao L
AD  - Department of Hematology, Beijing University, Beijing Jishuitan Hospital, 
      Beijing, China.
FAU - Wu, Yin
AU  - Wu Y
AD  - Department of Hematology, Beijing Chao-Yang Hospital Capital Medical University, 
      Beijing, China.
FAU - Chen, Wenming
AU  - Chen W
AD  - Department of Hematology, Beijing Chao-Yang Hospital Capital Medical University, 
      Beijing, China.
FAU - Zhuang, Junling
AU  - Zhuang J
AD  - Department of Hematology, Peking Union Medical College Hospital, Chinese Academy 
      of Medical Sciences, Beijing, China.
LA  - eng
PT  - Journal Article
DEP - 20230420
PL  - Switzerland
TA  - Front Oncol
JT  - Frontiers in oncology
JID - 101568867
PMC - PMC10157094
OTO - NOTNLM
OT  - high-risk disease
OT  - maintenance therapy
OT  - multicenter
OT  - multiple myeloma
OT  - real-world study
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2023/05/08 06:41
MHDA- 2023/05/08 06:42
PMCR- 2023/01/01
CRDT- 2023/05/08 03:57
PHST- 2022/08/26 00:00 [received]
PHST- 2023/03/29 00:00 [accepted]
PHST- 2023/05/08 06:42 [medline]
PHST- 2023/05/08 06:41 [pubmed]
PHST- 2023/05/08 03:57 [entrez]
PHST- 2023/01/01 00:00 [pmc-release]
AID - 10.3389/fonc.2023.1028571 [doi]
PST - epublish
SO  - Front Oncol. 2023 Apr 20;13:1028571. doi: 10.3389/fonc.2023.1028571. eCollection 
      2023.