Have the clinical signs of a serious type of blood cancer changed?

Researchers have found that, with new treatments for multiple myeloma, a serious type of blood cancer, clinicians should use different criteria to identify patients with poor chances of survival. The study was published online in Cancer.

Functional high-risk (FHR) multiple myeloma, which affects a subset of patients with blood cancer, is commonly defined as multiple myeloma that progresses within 18 months of starting treatment and has a survival prognosis of less than 2 years after progression.

Recently, however, the use of a four-part treatment regimen—including anti-CD38 antibodies, proteasome inhibitors, immunomodulatory agents and dexamethasone—followed by autologous stem cell transplantation has helped slow the cancer’s progression.

To update the definition of FHR multiple myeloma in the current era of combination therapy, investigators from the University of Alabama at Birmingham and the CoMMiT consortium analyzed information on 310 patients with newly diagnosed multiple myeloma who received this therapy and were followed for a median of 3.5 years.

Survival analyses indicated that cancer progression within 36 months of the start of combination therapy identified patients whose survival was likely to be less than 2 years from the time of progression.

Adding another treatment, called T-cell redirecting therapy, helped slow progression. This “FHR36” patient population, representing 16.4% of all treated patients, should be prioritized as candidates for early use of T-cell redirecting therapy and clinical trials of medications with novel mechanisms of action.

“The findings will help physicians choose therapies for this important minority of patients who have disease progression in the first 3 years after diagnosis and identify an important population whose greater need for treatment innovations should be addressed in the next generation of clinical trials,” said senior author Dr. Luciano J. Costa of the University of Alabama at Birmingham.

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Sadie Harley

BSc Life Sciences & Ecology. Microbiology lab background with pharmaceutical news experience in oil, gas, and renewable industries.

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Andrew Zinin

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