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Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial

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 (...

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Autores principales: Bahlis, N J, Corso, A, Mugge, L-O, Shen, Z-X, Desjardins, P, Stoppa, A-M, Decaux, O, de Revel, T, Granell, M, Marit, G, Nahi, H, Demuynck, H, Huang, S-Y, Basu, S, Guthrie, T H, Ervin-Haynes, A, Marek, J, Chen, G, Facon, T
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668494/
https://www.ncbi.nlm.nih.gov/pubmed/28373701
http://dx.doi.org/10.1038/leu.2017.111
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author Bahlis, N J
Corso, A
Mugge, L-O
Shen, Z-X
Desjardins, P
Stoppa, A-M
Decaux, O
de Revel, T
Granell, M
Marit, G
Nahi, H
Demuynck, H
Huang, S-Y
Basu, S
Guthrie, T H
Ervin-Haynes, A
Marek, J
Chen, G
Facon, T
author_facet Bahlis, N J
Corso, A
Mugge, L-O
Shen, Z-X
Desjardins, P
Stoppa, A-M
Decaux, O
de Revel, T
Granell, M
Marit, G
Nahi, H
Demuynck, H
Huang, S-Y
Basu, S
Guthrie, T H
Ervin-Haynes, A
Marek, J
Chen, G
Facon, T
author_sort Bahlis, N J
collection PubMed
description 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.
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spelling pubmed-56684942017-11-07 Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial Bahlis, N J Corso, A Mugge, L-O Shen, Z-X Desjardins, P Stoppa, A-M Decaux, O de Revel, T Granell, M Marit, G Nahi, H Demuynck, H Huang, S-Y Basu, S Guthrie, T H Ervin-Haynes, A Marek, J Chen, G Facon, T Leukemia Original Article 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. Nature Publishing Group 2017-11 2017-04-28 /pmc/articles/PMC5668494/ /pubmed/28373701 http://dx.doi.org/10.1038/leu.2017.111 Text en Copyright © 2017 The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Original Article
Bahlis, N J
Corso, A
Mugge, L-O
Shen, Z-X
Desjardins, P
Stoppa, A-M
Decaux, O
de Revel, T
Granell, M
Marit, G
Nahi, H
Demuynck, H
Huang, S-Y
Basu, S
Guthrie, T H
Ervin-Haynes, A
Marek, J
Chen, G
Facon, T
Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title_full Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title_fullStr Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title_full_unstemmed Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title_short Benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized FIRST trial
title_sort benefit of continuous treatment for responders with newly diagnosed multiple myeloma in the randomized first trial
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5668494/
https://www.ncbi.nlm.nih.gov/pubmed/28373701
http://dx.doi.org/10.1038/leu.2017.111
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