Table 2. Prognostic impact of response level in patients with newly diagnosed multiple myeloma: non-transplant studies.
| Reference Response criteria Study type | Treatment | Response | n | PFS/TTP/EFS (median, moa/rate, %) | OS (median, moa/rate, %) | ||||
|---|---|---|---|---|---|---|---|---|---|
| mOS | P-value | ||||||||
| Kyle et al.43 ECOG Ph 3 post hoc | VBMCP±IFN or HD-Cyc | CR PR | 85 335 | — | — | — | 61.2b 39.6b | — | <0.0001 |
| EFS | 3 yr | P-value | OS | 3 yr | P-value | ||||
| Offidani et al.59 EBMT Ph 2 | ThaDD | ⩾VGPR <VGPR | 28 22 | — | 78c 37c | 0.021 | — | 84 61 | 0.053 |
| EFS | 1 yr | ||||||||
| Palumbo et al.61 EBMT Ph 1/2 | MPR | CR/VGPR PR/MR | 20 33 | — | 100 88 | 0.034 | — | — | — |
| mTTP | mOS | ||||||||
| Harousseau et al.60 EBMT Ph 3 post hoc | VMP arm only | CR PR | 102 136 | NR 21.7 | — | 0.004d | 46.2 NR | — | 0.54d |
| PFS | 3 yr | P-value | 3 yr | P-value | |||||
| Gay et al.31 IMWG Pooled analysis of three Ph 3 studies | MP, MPT, VMP or VMPT→VT | CR VGPR PR | 195 212 397 | — | 67 27 27 | <0.001 CR versus VGPR and versus PR | — | 91 70 67 | <0.001 CR versus VGPR and versus PR |
| mOS | |||||||||
| Oivanen et al.9 CLMTF Pooled analysis of four prospective studies | MP or combination chemotherapy | Age ⩽70 yr CR 75% Response PR MR SD PD Age >70 yr CR 75% Response PR MR SD PD | 21 95 101 42 16 49 8 26 37 10 6 20 | — | — | — | 63 58 59 49 57 10 44 44 40 32 22 4 | — | <0.0001 for any category versus PD ⩽0.003 for any category versus PD |
Abbreviations: CLMTF, Chronic Leukemia-Myeloma Task Force; EBMT, European Group for Blood and Marrow Transplantation; ECOG, Eastern Cooperative Oncology Group; EFS, event-free survival; HD, high dose; mOS, median overall survival; MP, melphalan, prednisone; mPFS, median progression-free survival; MPT, melphalan, prednisone, thalidomide; mTTP, median time to progression; MPR, melphalan, prednisone, and lenalidomide; NR, not reached; ThaDD, thalidomide, dexamethasone and pegylated liposomal doxorubicin; VBMCP, vincristine, carmustine (BCNU), melphalan, cyclophosphamide and prednisone; VGPR, very good partial response; VMP, bortezomib, melphalan, prednisone; VT, bortezomib, thalidomide; yr, years.
Conversion to months for studies reporting other time increments.
From time of response, converted from years to months.
Landmark analysis after 4 months of treatment.
Multivariate analysis.