A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial
Thierry Facon
(1)
,
Meletios Dimopoulos
(2)
,
Nathalie Meuleman
(3)
,
Andrew Belch
(4)
,
Antoine Mohty
(5)
,
Wen-Ming Chen
(6)
,
Kihyun Kim
(7)
,
Elena Zamagni
(8)
,
Paula Rodriguez-Otero
(9)
,
William Renwick
(10)
,
Christian Rose
(11)
,
Adrian Tempescul
(12, 13)
,
Eileen Boyle
(2)
,
Salomon Manier
(2)
,
Michel Attal
(14)
,
Philippe Moreau
(15)
,
Margaret Macro
(16)
,
Xavier Leleu
(17)
,
Marie Lorraine Chretien
(18)
,
Heinz Ludwig
(19)
,
Shien Guo
(20)
,
Michael Sturniolo
(21)
,
Antoine Tinel
(22)
,
Mara Silvia Monzini
(21)
,
Bruno Costa
(22)
,
Vanessa Houck
(21)
,
Cyrille Hulin
(23)
,
Jean Yves Mary
(24)
1
CIC CHU ( Lille)/inserm
2 NKUA - National and Kapodistrian University of Athens
3 Institut Jules Bordet [Bruxelles]
4 Cross Cancer Institute [Edmonton, AB, Canada]
5 CHU Saint-Antoine [AP-HP]
6 Capital Medical University, Beijing
7 Samsung Medical Center Sungkyunkwan University School of Medicine
8 Azienda Ospedaliero-Universitaria
9 UNAV - Universidad de Navarra [Pamplona]
10 Western Health The University of Melbourne
11 UCL - Université catholique de Lille
12 CHU-Brest-Hemato - CHRU Brest - Service d'Hématologie
13 LBAI - Lymphocytes B, Autoimmunité et Immunothérapies
14 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
15 Hôpital Hôtel-Dieu de Nantes - CHU de Nantes - Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes
16 Hôpital Universitaire de Caen
17 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
18 CHU Dijon
19 Wilhelminenspital Vienna = Wilhelminen Hospital
20 Evidera
21 Celgene Corporation
22 Celgene International
23 Hôpital Haut-Lévêque [CHU Bordeaux]
24 AP-HP - Hopital Saint-Louis [AP-HP]
2 NKUA - National and Kapodistrian University of Athens
3 Institut Jules Bordet [Bruxelles]
4 Cross Cancer Institute [Edmonton, AB, Canada]
5 CHU Saint-Antoine [AP-HP]
6 Capital Medical University, Beijing
7 Samsung Medical Center Sungkyunkwan University School of Medicine
8 Azienda Ospedaliero-Universitaria
9 UNAV - Universidad de Navarra [Pamplona]
10 Western Health The University of Melbourne
11 UCL - Université catholique de Lille
12 CHU-Brest-Hemato - CHRU Brest - Service d'Hématologie
13 LBAI - Lymphocytes B, Autoimmunité et Immunothérapies
14 IUCT Oncopole - UMR 1037 - Institut Universitaire du Cancer de Toulouse - Oncopole
15 Hôpital Hôtel-Dieu de Nantes - CHU de Nantes - Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes
16 Hôpital Universitaire de Caen
17 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
18 CHU Dijon
19 Wilhelminenspital Vienna = Wilhelminen Hospital
20 Evidera
21 Celgene Corporation
22 Celgene International
23 Hôpital Haut-Lévêque [CHU Bordeaux]
24 AP-HP - Hopital Saint-Louis [AP-HP]
Elena Zamagni
- Fonction : Auteur
- PersonId : 786216
- ORCID : 0000-0003-1422-7305
Adrian Tempescul
- Fonction : Auteur
- PersonId : 908115
Eileen Boyle
- Fonction : Auteur
- PersonId : 772301
- ORCID : 0000-0001-8791-1744
- IdRef : 183072863
Michel Attal
- Fonction : Auteur
- PersonId : 944589
Philippe Moreau
- Fonction : Auteur
- PersonId : 759214
- ORCID : 0000-0003-1780-8746
Résumé
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.