Risk and Response-Adapted Treatment in Multiple Myeloma
Titouan Cazaubiel,Olga Mulas,Lydia Montes,Anaïs Schavgoulidze,Hervé Avet-Loiseau,Jill Corre,Aurore Perrot +6 more
Reads0
Chats0
TLDR
The advent of technologies detecting minimal residual disease gives the opportunity to define the quality of response to treatment with an unpreceded sensitivity and adapt treatment accordingly and even if molecular targeting is still nascent in myeloma, some molecular features are interesting to detect at relapse to determine optimal salvage treatments.Abstract:
Myeloma therapeutic strategies have been adapted to patients' age and comorbidities for a long time. However, although cytogenetics and clinical presentations (plasmablastic cytology; extramedullary disease) are major prognostic factors, until recently, all patients received the same treatment whatever their initial risk. No strong evidence allows us to use a personalized treatment according to one cytogenetic abnormality in newly diagnosed myeloma. Retrospective studies showed a benefit of a double autologous transplant in high-risk cytogenetics according to the International Myeloma Working Group definition (t(4;14), t(14;16) or del(17p)). Moreover, this definition has to be updated since other independent abnormalities, namely gain 1q, del(1p32), and trisomies 5 or 21, as well as TP53 mutations, are also prognostic. Another very strong predictive tool is the response to treatment assessed by the evaluation of minimal residual disease (MRD). We are convinced that the time has come to use it to adapt the strategy to a dynamic risk. Many trials are ongoing to answer many questions: when and how should we adapt the therapy, its intensity and duration. Nevertheless, we also have to take into account the clinical outcome for one patient, especially adverse events affecting his or her quality of life and his or her preferences for continuous/fixed duration treatment.read more
Citations
More filters
Journal ArticleDOI
Anti‐CD19 and anti‐BCMA CAR T cell therapy followed by lenalidomide maintenance after autologous stem‐cell transplantation for high‐risk newly diagnosed multiple myeloma
Xiaolan Shi,Lingzhi Yan,Jingjing Shang,Liqing Kang,Zhiling Yan,Song Jin,Ming Zhou,Huirong Chang,Feiran Gong,Jia-Zi Zhou,Guang Hua Chen,Jinlan Pan,Dandan Liu,Xiaming Zhu,Fang Tang,Ming-he Liu,Wei Liu,Feirong Yao,Lei Yu,Depei Wu,Chengcheng Fu +20 more
TL;DR: Although the sample size was small and there was a lack of control in this single‐arm study, the clinical benefits observed warrant ongoing randomized controlled trials.
Journal ArticleDOI
Advances and Perspectives in the Treatment of B-Cell Malignancies.
Marta Cuenca,Victor Peperzak +1 more
TL;DR: B-cell malignancies arise from different stages of B-cell differentiation and constitute a heterogeneous group of cancers including b-cell lymphomas, Bcell leukemias, and plasma cell dyscrasias.
Journal ArticleDOI
Prognostic Stratification of Multiple Myeloma Using Clinicogenomic Models: Validation and Performance Analysis of the IAC-50 Model
Adrián Mosquera Orgueira,Marta Sonia González Pérez,José Ángel Díaz Arias,Beatriz Antelo Rodríguez,Maria-Victoria Mateos +4 more
TL;DR: IAC-50 emerges as a powerful risk stratification model which might be considered forrisk stratification in newly diagnosed myeloma patients, in the context of clinical trials but also in real life.
Journal ArticleDOI
The Role of DNA Repair in Genomic Instability of Multiple Myeloma
TL;DR: How unrepaired DNA damage due to aberrant DNA repair response in MM exacerbates genomic instability and chromosomal abnormalities, enabling MM progression and drug resistance is highlighted.
Journal ArticleDOI
High Carbohydrate Diet Is Associated with Severe Clinical Indicators, but Not with Nutrition Knowledge Score in Patients with Multiple Myeloma
Ema Borsi,Costela Lacrimioara Serban,Cristina Potre,Ovidiu Potre,Salomeia Putnoky,Miruna Samfireag,Raluca Tudor,Ioana Ionita,Hortensia Ionita +8 more
TL;DR: In this article, the authors assessed nutrition knowledge and diet quality in a group of patients with a diagnosis of multiple myeloma and found that patients with high carbohydrate or low carbohydrate intake showed significant alteration of clinical parameters, such as hemoglobin, uric acid, albumin, total proteins, beta-2 microglobulin, percentage of plasmacytes in the bone marrow and D-dimers, compared to patients in the medium carbohydrate intake tertile.
References
More filters
Journal ArticleDOI
Frailty in Older Adults Evidence for a Phenotype
Linda P. Fried,Catherine M. Tangen,Jeremy D. Walston,Anne B. Newman,Calvin H. Hirsch,John S. Gottdiener,Teresa E. Seeman,Russell P. Tracy,Willem J. Kop,B Gregory Burke,Mary Ann McBurnie +10 more
TL;DR: This study provides a potential standardized definition for frailty in community-dwelling older adults and offers concurrent and predictive validity for the definition, and finds that there is an intermediate stage identifying those at high risk of frailty.
Journal Article
Cardiovascular Health Study Collaborative Research Group : Frailty in older adults : evidence for a phenotype
Journal ArticleDOI
Signatures of mutational processes in human cancer
Ludmil B. Alexandrov,Serena Nik-Zainal,Serena Nik-Zainal,David C. Wedge,Samuel Aparicio,Sam Behjati,Sam Behjati,Andrew V. Biankin,Graham R. Bignell,Niccolo Bolli,Niccolo Bolli,Åke Borg,Anne Lise Børresen-Dale,Anne Lise Børresen-Dale,Sandrine Boyault,Birgit Burkhardt,Adam Butler,Carlos Caldas,Helen Davies,Christine Desmedt,Roland Eils,Jorunn E. Eyfjord,John A. Foekens,Mel Greaves,Fumie Hosoda,Barbara Hutter,Tomislav Ilicic,Sandrine Imbeaud,Sandrine Imbeaud,Marcin Imielinsk,Natalie Jäger,David T. W. Jones,David T. Jones,Stian Knappskog,Stian Knappskog,Marcel Kool,Sunil R. Lakhani,Carlos López-Otín,Sancha Martin,Nikhil C. Munshi,Nikhil C. Munshi,Hiromi Nakamura,Paul A. Northcott,Marina Pajic,Elli Papaemmanuil,Angelo Paradiso,John V. Pearson,Xose S. Puente,Keiran Raine,Manasa Ramakrishna,Andrea L. Richardson,Andrea L. Richardson,Julia Richter,Philip Rosenstiel,Matthias Schlesner,Ton N. Schumacher,Paul N. Span,Jon W. Teague,Yasushi Totoki,Andrew Tutt,Rafael Valdés-Mas,Marit M. van Buuren,Laura van ’t Veer,Anne Vincent-Salomon,Nicola Waddell,Lucy R. Yates,Icgc PedBrain,Jessica Zucman-Rossi,Jessica Zucman-Rossi,P. Andrew Futreal,Ultan McDermott,Peter Lichter,Matthew Meyerson,Matthew Meyerson,Sean M. Grimmond,Reiner Siebert,Elias Campo,Tatsuhiro Shibata,Stefan M. Pfister,Stefan M. Pfister,Peter J. Campbell,Peter J. Campbell,Peter J. Campbell,Michael R. Stratton,Michael R. Stratton +84 more
TL;DR: It is shown that hypermutation localized to small genomic regions, ‘kataegis’, is found in many cancer types, and this results reveal the diversity of mutational processes underlying the development of cancer.
Journal ArticleDOI
A global clinical measure of fitness and frailty in elderly people
Kenneth Rockwood,Xiaowei Song,Chris MacKnight,Howard Bergman,David B. Hogan,Ian McDowell,Arnold Mitnitski +6 more
TL;DR: The ability of the Clinical Frailty Scale to predict death or need for institutional care, and correlated the results with those obtained from other established tools are determined.
Journal ArticleDOI
Bortezomib plus melphalan and prednisone for initial treatment of multiple myeloma.
Jesús F. San Miguel,Rudolf Schlag,Nuriet K. Khuageva,Meletios A. Dimopoulos,Ofer Shpilberg,Martin Kropff,Ivan Spicka,Maria Teresa Petrucci,Antonio Palumbo,Olga Samoilova,Anna Dmoszynska,Kudrat Abdulkadyrov,Rik Schots,Bin Jiang,Maria-Victoria Mateos,Kenneth C. Anderson,Dixie Lee Esseltine,Kevin Liu,Andrew Cakana,Helgi van de Velde,Paul G. Richardson +20 more
TL;DR: Bortezomib plus melphalan-prednisone alone in patients with newly diagnosed myeloma who were ineligible for high-dose therapy was superior to melphAlan-predisonsone alone.
Related Papers (5)
MRD Testing in Multiple Myeloma: The Main Future Driver for Modern Tailored Treatment.
2021 European Myeloma Network review and consensus statement on smoldering multiple myeloma: how to distinguish (and manage) Dr. Jekyll and Mr. Hyde.
Pellegrino Musto,Monika Engelhardt,Jo Caers,Niccolo Bolli,Martin Kaiser,Niels W.C.J. van de Donk,Evangelos Terpos,Annemiek Broijl,Carlos Fernández de Larrea,Hartmut Goldschmidt,Roman Hájek,Annette Juul Vangsted,Elena Zamagni,Sonja Zweegman,Michele Cavo,Meletios A. Dimopoulos,Hermann Einsele,Heinz Ludwig,Giovanni Barosi,Mario Boccadoro,Maria-Victoria Mateos,Pieter Sonneveld,Jesús F. San Miguel +22 more