Publicaciones científicas
Minimally Invasive Assessment of Peripheral Residual Disease During Maintenance or Observation in Transplant-Eligible Patients With Multiple Myeloma
Marta Lasa 1, Laura Notarfranchi 1 2, Cristina Agullo 3, Carmen Gonzalez 1, Sergio Castro 3, Jose J Perez 3, Leire Burgos 1, Camila Guerrero 1, Maria Jose Calasanz 1, Juan Flores-Montero 3, Albert Oriol 4, Joan Bargay 5, Rafael Rios 6, Valentin Cabañas 7, Carmen Cabrera 8, Rafael Martinez-Martinez 9, Cristina Encinas 10, Felipe De Arriba 11, Miguel-Teodoro Hernandez 12, Luis Palomera 13, Alberto Orfao 14, Joaquin Martinez-Lopez 15, Maria-Victoria Mateos 3, Jesus San-Miguel 1, Juan Jose Lahuerta 15, Laura Rosiñol 16, Joan Blade 16, Maria Teresa Cedena 15, Noemi Puig 3, Bruno Paiva 1; PETHEMA/GEM Cooperative Group
Abstract
Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported.In multiple myeloma (MM), measurable residual disease (MRD) is assessed in bone marrow (BM). However, less invasive evaluation of peripheral residual disease (PRD) in blood could be advantageous and less cumbersome. We investigated the prognostic value of PRD monitoring after 24 cycles of maintenance in 138 transplant-eligible patients with MM enrolled in the GEM2012MENOS65/GEM2014MAIN clinical trials. PRD was assessed using next-generation flow (NGF) and mass spectrometry (MS).
Positive PRD by NGF in 16/138 (11.5%) patients was associated with a 13-fold increased risk of progression and/or death; median progression-free survival (PFS) and overall survival (OS) were 2.5 and 47 months, respectively. Considering patients' MRD status in BM as the reference, PRD detection using NGF showed positive and negative predictive values of 100% and 73%, respectively. Presence of PRD helped identifying patients at risk of imminent progression among those with positive MRD in BM.
Patients with undetectable PRD according to both NGF and MS showed 2-year PFS and OS rates of 97% and 100%, respectively. In multivariate analyses including the Revised International Staging System and the complete remission status, only MRD in BM and PRD by NGF showed independent prognostic value for PFS. This study supports the use of less invasive PRD monitoring during maintenance or observation in transplant-eligible patients with MM.
CITA DEL ARTICULO J Clin Oncol. 2024 Oct 1:JCO2400635. doi: 10.1200/JCO.24.00635. Online ahead of print.
Nuestros autores
