Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma tr
- PDF / 695,941 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 3 Downloads / 175 Views
ORIGINAL ARTICLE
Clinical impact of frailty on treatment outcomes of elderly patients with relapsed and/or refractory multiple myeloma treated with lenalidomide plus dexamethasone Ho Sup Lee1 · Kihyun Kim2 · Je‑Jung Lee3 · Sung‑Soo Yoon4 · Soo‑Mee Bang5 · Jin Seok Kim6 · Hyeon‑Seok Eom7 · Dok Hyun Yoon8 · Yoojin Lee9,12 · Ho‑Jin Shin10 · Yong Park11 · Jae‑Cheol Jo12 · Won Sik Lee13 · Young Rok Do14 · Yeung‑Chul Mun15 · Mark Hong Lee16 · Hyo Jung Kim17 · Sung‑Hyun Kim18 · Min Kyoung Kim19 · Sung‑Nam Lim20 · Seong Kyu Park21 · Jun Ho Yi22 · Jae Hoon Lee23 · Chang‑Ki Min24 · The Korean Multiple Myeloma Working Party (KMMWP) Received: 30 June 2020 / Revised: 17 August 2020 / Accepted: 25 August 2020 © Japanese Society of Hematology 2020
Abstract We compared efficacy and safety, according to frailty, of elderly patients with relapsed and refractory multiple myeloma (RRMM) treated with lenalidomide and dexamethasone (Rd), for whom bortezomib treatment had failed. Patients, 164 (52.9%) and 146 (47.1%), were classified as non-frail and frail using a simplified frailty scale. The overall response rates (ORR) and survival outcomes were lower in frail than in non-frail patients (ORR: 56.2% vs. 67.7%, P = 0.069; median progression free survival: 13.17 vs. 17.80 months, P = 0.033; median overall survival: 23.00 vs. 36.27 months, P = 0.002, respectively). The number of treatment emergent adverse events in grade 3 or worse was higher in frail than in non-frail patients (41.8% vs. 24.4%, P = 0.002, respectively). In frail patients, independent poor prognostic factors for survival were two or more Charlson comorbidity index (CCI) score, prior to exposure to both bortezomib and thalidomide, and achieved less than partial response In conclusion, frailty could predict clinical outcomes of Rd treatment in elderly patients with RRMM who had failed prior bortezomib. In frail patients, lower CCI in addition to less previous treatment exposure and deep response were associated with better survival. Keywords Elderly multiple myeloma · Relapsed and refractory · Lenalidomide and dexamethasone · Frailty · Survival
Introduction Multiple myeloma (MM) is a neoplastic disease that typically affects elderly patients. MM is most frequently diagnosed in people aged 65–74 years, with a median age at diagnosis of approximately 70 years [1]. Over the past decades, one of the major advances in the treatment regimen of patients with MM has been the introduction of novel therapies, including immune-modifying drugs (thalidomide and lenalidomide) and proteasome inhibitors such as bortezomib Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12185-020-02988-6) contains supplementary material, which is available to authorized users. * Chang‑Ki Min [email protected] Extended author information available on the last page of the article
[2, 3]. However, improved efficacy of therapeutic approaches must be balanced with the risk of toxicity of therapy. In particular, older adults may be particularly vulnerable
Data Loading...
