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Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma

SIMPLE SUMMARY: Survival of patients with multiple myeloma continues to improve over time in parallel with the development of new treatments. The combination of novel agents in the first-line setting appears to be the main factor driving improvement, resulting in overall survival (OS) of more than 1...

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Autores principales: Puertas, Borja, González-Calle, Verónica, Sobejano-Fuertes, Eduardo, Escalante, Fernando, Queizán, José A., Bárez, Abelardo, Labrador, Jorge, Alonso-Alonso, José María, García de Coca, Alfonso, Cantalapiedra, Alberto, Villaescusa, Teresa, Aguilar-Franco, Carlos, Alejo-Alonso, Elena, Rey-Bua, Beatriz, López-Corral, Lucía, García-Sanz, Ramón, Puig, Noemi, Gutiérrez, Norma C., Mateos, María-Victoria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000382/
https://www.ncbi.nlm.nih.gov/pubmed/36900349
http://dx.doi.org/10.3390/cancers15051558
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author Puertas, Borja
González-Calle, Verónica
Sobejano-Fuertes, Eduardo
Escalante, Fernando
Queizán, José A.
Bárez, Abelardo
Labrador, Jorge
Alonso-Alonso, José María
García de Coca, Alfonso
Cantalapiedra, Alberto
Villaescusa, Teresa
Aguilar-Franco, Carlos
Alejo-Alonso, Elena
Rey-Bua, Beatriz
López-Corral, Lucía
García-Sanz, Ramón
Puig, Noemi
Gutiérrez, Norma C.
Mateos, María-Victoria
author_facet Puertas, Borja
González-Calle, Verónica
Sobejano-Fuertes, Eduardo
Escalante, Fernando
Queizán, José A.
Bárez, Abelardo
Labrador, Jorge
Alonso-Alonso, José María
García de Coca, Alfonso
Cantalapiedra, Alberto
Villaescusa, Teresa
Aguilar-Franco, Carlos
Alejo-Alonso, Elena
Rey-Bua, Beatriz
López-Corral, Lucía
García-Sanz, Ramón
Puig, Noemi
Gutiérrez, Norma C.
Mateos, María-Victoria
author_sort Puertas, Borja
collection PubMed
description SIMPLE SUMMARY: Survival of patients with multiple myeloma continues to improve over time in parallel with the development of new treatments. The combination of novel agents in the first-line setting appears to be the main factor driving improvement, resulting in overall survival (OS) of more than 12 and 8 years in patients aged ≤ 70 and >70 years, respectively. In addition, different baseline characteristics have been identified that favorably affected the probability of long-term survival (≥10 years) compared with early death (≤2 years). Therefore, we could conclude that multiple myeloma has become a chronic and even curable disease, in a subset of patients with the current therapeutic approaches. ABSTRACT: (1) Background: New therapeutic strategies have improved the prognosis of multiple myeloma (MM), changing the accepted view of this disease from being incurable to treatable. (2) Methods: We studied 1001 patients with MM between 1980 and 2020, grouping patients into ten-year periods by diagnosis 1980–1990, 1991–2000, 2001–2010 and 2011–2020. (3) Results: After 65.1 months of follow-up, the median OS of the cohort was 60.3 months, and OS increased significantly over time: 22.4 months in 1980–1990, 37.4 months in 1991–2000, 61.8 months in 2001–2010 and 103.6 months in 2011–2020 (p < 0.001). Using novel agents in the front-line setting for myeloma patients yielded a significantly better OS than in those treated with conventional therapies, especially when combinations of at least two novel agents were used. The median OS of patients treated with the combination of at least two novel agents in induction was significantly prolonged compared to those treated with a single novel agent or conventional therapy in induction: 143.3 vs. 61.0 vs. 42.2 months (p < 0.001). The improvement was apparent in all patients regardless of age at diagnosis. In addition, 132 (13.2%) patients were long-term survivors (median OS ≥ 10 years). Some independent clinical predictors of long-term survival were identified: ECOG < 1, age at diagnosis ≤ 65 years, non-IgA subtype, ISS-1 and standard-risk cytogenetic. Achieving CR and undergoing ASCT were positively associated with >10 years of survival. (4) Conclusions: The combination of novel agents appears to be the main factor for the improvement in survival in MM, which is becoming a chronic and even curable disease in a subtype of patients without high-risk features.
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spelling pubmed-100003822023-03-11 Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma Puertas, Borja González-Calle, Verónica Sobejano-Fuertes, Eduardo Escalante, Fernando Queizán, José A. Bárez, Abelardo Labrador, Jorge Alonso-Alonso, José María García de Coca, Alfonso Cantalapiedra, Alberto Villaescusa, Teresa Aguilar-Franco, Carlos Alejo-Alonso, Elena Rey-Bua, Beatriz López-Corral, Lucía García-Sanz, Ramón Puig, Noemi Gutiérrez, Norma C. Mateos, María-Victoria Cancers (Basel) Article SIMPLE SUMMARY: Survival of patients with multiple myeloma continues to improve over time in parallel with the development of new treatments. The combination of novel agents in the first-line setting appears to be the main factor driving improvement, resulting in overall survival (OS) of more than 12 and 8 years in patients aged ≤ 70 and >70 years, respectively. In addition, different baseline characteristics have been identified that favorably affected the probability of long-term survival (≥10 years) compared with early death (≤2 years). Therefore, we could conclude that multiple myeloma has become a chronic and even curable disease, in a subset of patients with the current therapeutic approaches. ABSTRACT: (1) Background: New therapeutic strategies have improved the prognosis of multiple myeloma (MM), changing the accepted view of this disease from being incurable to treatable. (2) Methods: We studied 1001 patients with MM between 1980 and 2020, grouping patients into ten-year periods by diagnosis 1980–1990, 1991–2000, 2001–2010 and 2011–2020. (3) Results: After 65.1 months of follow-up, the median OS of the cohort was 60.3 months, and OS increased significantly over time: 22.4 months in 1980–1990, 37.4 months in 1991–2000, 61.8 months in 2001–2010 and 103.6 months in 2011–2020 (p < 0.001). Using novel agents in the front-line setting for myeloma patients yielded a significantly better OS than in those treated with conventional therapies, especially when combinations of at least two novel agents were used. The median OS of patients treated with the combination of at least two novel agents in induction was significantly prolonged compared to those treated with a single novel agent or conventional therapy in induction: 143.3 vs. 61.0 vs. 42.2 months (p < 0.001). The improvement was apparent in all patients regardless of age at diagnosis. In addition, 132 (13.2%) patients were long-term survivors (median OS ≥ 10 years). Some independent clinical predictors of long-term survival were identified: ECOG < 1, age at diagnosis ≤ 65 years, non-IgA subtype, ISS-1 and standard-risk cytogenetic. Achieving CR and undergoing ASCT were positively associated with >10 years of survival. (4) Conclusions: The combination of novel agents appears to be the main factor for the improvement in survival in MM, which is becoming a chronic and even curable disease in a subtype of patients without high-risk features. MDPI 2023-03-02 /pmc/articles/PMC10000382/ /pubmed/36900349 http://dx.doi.org/10.3390/cancers15051558 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Puertas, Borja
González-Calle, Verónica
Sobejano-Fuertes, Eduardo
Escalante, Fernando
Queizán, José A.
Bárez, Abelardo
Labrador, Jorge
Alonso-Alonso, José María
García de Coca, Alfonso
Cantalapiedra, Alberto
Villaescusa, Teresa
Aguilar-Franco, Carlos
Alejo-Alonso, Elena
Rey-Bua, Beatriz
López-Corral, Lucía
García-Sanz, Ramón
Puig, Noemi
Gutiérrez, Norma C.
Mateos, María-Victoria
Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title_full Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title_fullStr Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title_full_unstemmed Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title_short Novel Agents as Main Drivers for Continued Improvement in Survival in Multiple Myeloma
title_sort novel agents as main drivers for continued improvement in survival in multiple myeloma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10000382/
https://www.ncbi.nlm.nih.gov/pubmed/36900349
http://dx.doi.org/10.3390/cancers15051558
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