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
Abstract : 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.
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https://hal.univ-brest.fr/hal-02271238
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Submitted on : Monday, August 26, 2019 - 4:14:41 PM
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Thierry Facon, Meletios Dimopoulos, Nathalie Meuleman, Andrew Belch, Antoine Mohty, et al.. A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial. Leukemia, Nature Publishing Group: Open Access Hybrid Model Option B, 2019, ⟨10.1038/s41375-019-0539-0⟩. ⟨hal-02271238⟩

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