2021
Survival benefit of ixazomib, lenalidomide and dexamethasone (IRD) over lenalidomide and dexamethasone (Rd) in relapsed and refractory multiple myeloma patients in routine clinical practice
MINARIK, J., T. PIKA, J. RADOCHA, A. JUNGOVA, J. STRAUB et. al.Základní údaje
Originální název
Survival benefit of ixazomib, lenalidomide and dexamethasone (IRD) over lenalidomide and dexamethasone (Rd) in relapsed and refractory multiple myeloma patients in routine clinical practice
Autoři
MINARIK, J. (203 Česká republika, garant), T. PIKA (203 Česká republika), J. RADOCHA (203 Česká republika), A. JUNGOVA (203 Česká republika), J. STRAUB (203 Česká republika), T. JELINEK (203 Česká republika), Luděk POUR (203 Česká republika, domácí), P. PAVLICEK (203 Česká republika), M. MISTRIK (203 Česká republika), Lucie BROŽOVÁ (203 Česká republika), P. KRHOVSKA (203 Česká republika), K. MACHALKOVA (203 Česká republika), P. JINDRA (203 Česká republika), I. SPICKA (203 Česká republika), H. PLONKOVA (203 Česká republika), Martin ŠTORK (203 Česká republika, domácí), J. BACOVSKY (203 Česká republika), L. CAPKOVA (203 Česká republika), M. SYKORA (203 Česká republika), P. KESSLER (203 Česká republika), L. STEJSKAL (203 Česká republika), A. HEINDORFER (203 Česká republika), J. ULLRYCHOVA (203 Česká republika), T. SKACEL (203 Česká republika), V. MAISNAR (203 Česká republika) a R. HAJEK (203 Česká republika)
Vydání
BMC Cancer, LONDON, BMC, 2021, 1471-2407
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30204 Oncology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 4.638
Kód RIV
RIV/00216224:14110/21:00120101
Organizační jednotka
Lékařská fakulta
UT WoS
000610557500001
Klíčová slova anglicky
Multiple myeloma; Ixazomib; Lenalidomide; Dexamethasone; Clinical trial; Patient registry
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 3. 6. 2021 09:42, Mgr. Tereza Miškechová
Anotace
V originále
Background We have performed a head to head comparison of all-oral triplet combination of ixazomib, lenalidomide and dexamethasone (IRD) versus lenalidomide and dexamethasone (RD) in patients with relapsed and refractory multiple myeloma (RRMM) in the routine clinical practice. Methods A total of 344 patients treated with IRD (N = 127) or RD (N = 217) were selected for analysis from the Czech Registry of Monoclonal Gammopathies (RMG). Descriptive statistics were used to assess patient's characteristics associated with the respective therapy. The primary endpoint was progression free survival (PFS), secondary end points included response rates and overall survival (OS). Survival endpoints were plotted using Kaplan-Meier methodology at 95% Greenwood confidence interval. Univariable and multivariable Cox proportional hazards models were used to evaluate the effect of treatment regimens and the significance of uneven variables. Statistical tests were performed at significance level 0.05. Results In the whole cohort, median PFS for IRD was 17.5 and for RD was 11.5 months favoring the all-oral triplet, p = 0.005; in patients within relapse 1-3, the median PFS was 23.1 vs 11.6 months, p = 0.001. The hazard ratio for PFS was 0.67 (95% confidence interval [CI] 0.51-0.89, p = 0.006). The PFS advantage translated into improved OS for patients treated with IRD, median 36.6 months vs 26.0 months (p = 0.008). The overall response rate (ORR) was 73.0% in the IRD group vs 66.2% in the RD group with a complete response rate (CR) of 11.1% vs 8.8%, and very good partial response (VGPR) 22.2% vs 13.9%, IRD vs RD respectively. The IRD regimen was most beneficial in patients <= 75 years with ISS I, II, and in the first and second relapse. Patients with the presence of extramedullary disease did not benefit from IRD treatment (median PFS 6.5 months). Both regimens were well tolerated, and the incidence of total as well as grade 3/4 toxicities was comparable. Conclusions Our analysis confirms the results of the TOURMALINE-MM1 study and shows benefit of all-oral triplet IRD treatment versus RD doublet. It demonstrates that the addition of ixazomib to RD improves key survival endpoints in patients with RRMM in a routine clinical setting.
Návaznosti
NV17-29343A, projekt VaV |
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