TY - JOUR
T1 - A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial
AU - Facon, Thierry
AU - Dimopoulos, Meletios A.
AU - Meuleman, Nathalie
AU - Belch, Andrew
AU - Mohty, Mohamad
AU - Chen, Wen Ming
AU - Kim, Kihyun
AU - Zamagni, Elena
AU - Rodriguez-Otero, Paula
AU - Renwick, William
AU - Rose, Christian
AU - Tempescul, Adrian
AU - Boyle, Eileen
AU - Manier, Salomon
AU - Attal, Michel
AU - Moreau, Philippe
AU - Macro, Margaret
AU - Leleu, Xavier
AU - Lorraine Chretien, Marie
AU - Ludwig, Heinz
AU - Guo, Shien
AU - Sturniolo, Michael
AU - Tinel, Antoine
AU - Silvia Monzini, Mara
AU - Costa, Bruno
AU - Houck, Vanessa
AU - Hulin, Cyrille
AU - Yves Mary, Jean
N1 - Publisher Copyright:
© 2019, The Author(s).
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores for age, Charlson Comorbidity Index (CCI), and Eastern Cooperative Oncology Group performance status (ECOG PS), instead of the EQ-5D quality-of-life questionnaire, as previously reported. ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%). Frail patients experienced worse progression-free and overall survival vs nonfrail patients. Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III). Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events. Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients.
AB - Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores for age, Charlson Comorbidity Index (CCI), and Eastern Cooperative Oncology Group performance status (ECOG PS), instead of the EQ-5D quality-of-life questionnaire, as previously reported. ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%). Frail patients experienced worse progression-free and overall survival vs nonfrail patients. Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III). Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events. Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients.
UR - https://www.scopus.com/pages/publications/85071075597
U2 - 10.1038/s41375-019-0539-0
DO - 10.1038/s41375-019-0539-0
M3 - Article
C2 - 31427722
AN - SCOPUS:85071075597
SN - 0887-6924
VL - 34
SP - 224
EP - 233
JO - Leukemia
JF - Leukemia
IS - 1
ER -