Gain 1q21 vs. Velcade and thalidomide based regimen
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| Year of publication | 2009 |
| Type | Conference abstract |
| MU Faculty or unit | |
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| Description | Introduction The presence of chromosomal aberrations detected by FISH in plasma cells is considered to be an important prognostic factor for patients with multiple myeloma. This study is aimed at comparison of ability to overcome the unfavourable prognostic impact of gain1q21 and other cytogenetic aberrations by treatment regimens based on Velcade (V) or thalidomide (T). Material & Methods A total of 42 patients (median follow-up 16.0 months; median of previous therapy lines 1) were treated by V-based regimen (48% together with glucocorticoids and alkylating agens; 30% with anthracycline +/- dex; 22% with dex only). A total of 33 (median follow-up 19.7 months; median of previous therapy lines 1) were treated by T-based regimen (94% together with and cyclophosphamide; 6% with dex only). Both groups were separately examined by cIg-FISH for presence of 1q21 gain, del 13q14, del 17p13, t(4;14) and hyperdiploidy/nonhyperdiploidy. Results for patients treated by Velcade based regimen Gain 1q21 was detected in 80% (24/30) pts. Comparison of ORR in pos. and neg. pts was not significant. PFS median of gain 1q21 pos. vs. neg. pts. reached 8.6 vs. 7.6 months; P=0.556; for del 13q14 reached 6.7 vs. 8.5 months; P=0.664; for del 17p13 reached 4.8 vs. 8.2 months; P=0.541; and for t(4;14) reached 8.2 vs. 7.7 months; P=0.591. Results for patients treated by thalidomide based regimen Gain 1q21 was detected in 59% (16/27) pts. It seems to be worst treatment response in pts. with t(4;14), whereas 33% (2/6) of pts. with t(4;14) achieved ORR vs. 73% (16/22) of pts. lacking t(4;14) (P=0.039). PFS median of pos. vs. neg. pts. for gain 1q21 reached 7.8 vs. 12.4; P=0.045. For del 13q14 reached 11.2 vs. 7.7 months; P=0.566; for del 17p13 pos. NR vs. 9.8 months; P=0.021 and for t(4;14) reached 6.7 vs. 10.4 months; P=0.882. Summary / Conclusions The difference in PFS in gain 1q21 pos. and neg. pts. treated by T suggests that thalidomide based regimen is not able to overcome unfavourable prognostic impact of this aberration in contrary of treatment based on Velcade based regimen which probably may overcome poor prognosis of gain 1q21. Supported by grants LC06027, MSM0021622415, MSM0021622434 and IGA NR 9317-3 and NR 9225. |
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