Patterns of relapse from complete response during different maintenance strategies

Description

The aim of the IMS funded project was to investigate whether different subgroups of patients (i.e. defined by baseline clinical and biological characteristics) with newly-diagnosed multiple myeloma who have achieved a complete response (CR) after autologous stem cell transplantation (ASCT) benefit from different maintenance treatments or if some of them even require observation only. Due to the heterogeneity of employed maintenance therapies and the fact that not all patients achieve a complete response post-ASCT, it was necessary to combine several datasets. Based on these collected and harmonized datasets, the ultimate goal was to identify clinical characteristics that differentiate patients with relapse / progression from CR who have benefited from different maintenance strategies (i.e. lenalidomide, bortezomib, observation / placebo). Overall, data from approximately 3300 patients (amongst whom at least 600-700 had achieved a complete response post ASCT) from the Buffalo CCC Myeloma Registry, the Heidelberg University Myeloma Registry, the ALLIANCE trial CALGB100104, and the GMMG-HD3, – HD4, -MM5 and -HD6 trials were approved for inclusion in this multi-cohort analysis. The protected research time within the IMS Career Development Award allowed to further pursue collaboration with the EMN in an associated parallel multi-cohort project on early morbidity and mortality during induction therapy in patients with newly-diagnosed multiple myeloma. Herein, data from the HO65, HO95/EMN02 trial and the GMMG-HD7 trial were included as validation cohorts. In this project, a novel risk score to predict severe infection or death during induction therapy was built and independently validated based on rapidly available clinical parameters.