Completion of premaintenance phases in total therapies 2 and 3 improves clinical outcomes in multiple myeloma: an important variable to be considered in clinical trial designs

Cancer
Bart BarlogieJohn Crowley

Abstract

Total Therapy (TT) programs are complex and their execution over the course of several years is fraught with patient attrition due to failure and toxicity of therapy and patient/physician acceptance. The impact of completion versus noncompletion of intended treatment steps was examined in protocols TT2 (n=668) and TT3 (n=303) on overall survival (OS) and event-free survival (EFS). By using appropriate landmarks of 36 months with TT2 and 18 months with TT3, representing the maxima to completion of premaintenance phases, postconsolidation OS was superior for 211 patients completing versus 311 patients not completing premaintenance steps on TT2 (P=.001), which also pertained to the 161 patients completing versus 47 not completing intended treatment steps on TT3 (P=.01). On multivariate analysis that included all patients, completion of therapy independently favored longer OS and EFS in the context of both standard prognostic factors and gene expression profiling-defined risk; in addition, TT3 prolonged EFS over results obtained with TT2. 1) Completion of intended therapy was a significant independent variable conferring superior OS and EFS in TT programs; and 2) after adjusting for completion of therapy, EFS was still superior wit...Continue Reading

References

Jul 1, 1995·Cancer Genetics and Cytogenetics·J R SawyerB Barlogie
Dec 26, 2003·The New England Journal of Medicine·Michel AttalUNKNOWN InterGroupe Francophone du Myélome
Jan 13, 2006·The New England Journal of Medicine·Ching-Hon Pui, William E Evans
Mar 10, 2006·The New England Journal of Medicine·Bart BarlogieJohn Crowley
Dec 7, 2006·Blood·Antonio PalumboUNKNOWN Gruppo Italiano Malattie Ematologicche dell'Adulto
Jun 27, 2007·British Journal of Haematology·Bart BarlogieJohn D Shaughnessy

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Citations

Mar 13, 2010·Clinical Lymphoma, Myeloma & Leukemia·Somashekar G KrishnaElias Anaissie
Jul 17, 2012·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·L ZhaoC J Bruns
Feb 13, 2010·Blood·Sergio Giralt
Sep 15, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Pieter SonneveldMichele Cavo

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