Independent predictors of early relapse multiple myeloma (MM) include TP53 mutation, high LDH levels, amp1q and IGLL5 mutation, according to the findings of a study presented at the 17th International Myeloma Workshop.
To conduct this study, the researchers analyzed data on 1,151 patients enrolled in the Multiple Myeloma Research Foundation (MMRF) CoMMpass trial. The cohort was comprised of 760 real-world patients and 166 patients enrolled in clinical trials. The data cut-off for patients co-enrolled in the NCT02203643 study was May 30, 2018. Patients with a time-to-progression (TTP) of 18 months or less were defined as early progressors, and all cytogenetic data were defined using SeqFISH. Each patient’s therapy was categorized according to their initial induction therapy, autologous stem-cell transplantation (ASCT) and maintenance therapy. Subsequently, the researchers performed a univariate analysis of clinical and biological factors.
The most frequent induction therapy was VRd followed by bortezomib + chemotherapy triplet, and maintenance was achieved by 74% of evaluable patients with early progression occurring in 21% of patients. Among patients defined as early progressors, 16.2% were primary refractory, 46.6% relapsed while receiving active treatment during the first year. The researchers adjusted the multivariate logistic regression model to avoid any bias. They observed that independent factors increasing the risk of early progression were TP53 mutation (OR=3.63, P<0.001), high LDH levels (OR=2.23, P=0.026), amp1q positivity (OR=1.56, P=0.027) and IGLL5 mutation (OR=1.73, P=0.025).
“With the limitations of a mixed real-world + clinical-trial population and a nonrandomized evaluation, treatment intensification with ASCT and maintenance lowered the risk of early progression,” the researchers wrote in their conclusion.
D’Agostino, M, et al. Clinical and Biological Early Relapse Predictors in Multiple Myeloma: An Analysis from the MMRF CoMMpass Study. Presented at the 17th International Myeloma Workshop; September 12-15, 2019; Boston, MA.