Outcomes of patients with t(11;14) multiple myeloma: An international myeloma working group (IMWG) multicenter study.

Authors

null

Brian G. Durie

Cedars-Sinai Comprehensive Cancer Center, Los Angeles, CA

Brian G. Durie , Hartmut Goldschmidt , Maria-Victoria Mateos , Veronica Gonzalez , Juan Du , Kihyun Kim , Giampaolo Merlini , Silvia Mangiacavalli , Chang Ki Min , Meletios A. Dimopoulos , Efstathios Kastritis , Heinz Ludwig , Graca Esteves , Hiroshi Handa , Fernando Escalante , Carlos Fernández de Larrea Rodríguez , Michel Delforge , Chris Cameron , S. Vincent Rajkumar , Shaji Kumar

Organizations

Cedars-Sinai Comprehensive Cancer Center, Los Angeles, CA, University of Heidelberg, Heidelberg, Germany, University of Salamanca Hospital/IBSAL, Salamanca, Spain, University Hospital of Salamanca, Salamanca, Spain, Department of Hematology, Myeloma & Lymphoma Center, Shanghai Chang Zheng Hospital, Shanghai, China, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, Scientific Institute Policlinico San Matteo, University of Pavia, Pavia, Italy, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea, National and Kapodistrian University of Athens, Athens, Greece, National and Kapodistrian University of Athens School of Medicine, Athens, Greece, Wilhelminen Cancer Research Institute, Wilhelminenspital, Department of Medicine, Center of Oncology, Hematology and Palliative Care, Vienna, Austria, Centro Hospitalar Lisboa Norte, Lisboa, Portugal, Gunma University, Gunma, Japan, Complejo Asistencial Universitario de León, Leon, Spain, Hospital Clínic de Barcelona., Barcelona, Spain, UZ Leuven, Leuven, Belgium, Cornerstone Research Group, Inc., Burlington, ON, Canada, Mayo Clinic, Rochester, MN

Research Funding

Pharmaceutical/Biotech Company

Background: Multiple myeloma (MM) is a heterogeneous disease with varying survival outcomes depending on the presence of certain genetic abnormalities. Common abnormalities include trisomies, translocations involving chromosome 14, and amplifications or deletions of chromosomes 1, 13, and 17. t(11;14), occurring in approx. 15% of patients (pts) with MM, is considered a standard risk abnormality, but recent data suggest that the prognosis may be inferior to what had been expected. This is of particular relevance as new therapeutic options such as the BCL-2 inhibitor venetoclax has been shown to be effective in t(11;14) pts. Methods: This was a multicenter study designed and conducted by the IMWG, to identify the outcomes of pts with t(11;14) using a retrospective cohort of pts. Pts with MM diagnosed between 2005 and 2015 with t(11;14) identified on FISH performed within six months (mos) of diagnosis, and with treatment details available and if alive, a minimum of 12 mos of follow up, were enrolled. Results: The current analysis includes 848 pts with a median age of 64.4 years; 60.0% are male. The median follow-up from diagnosis for the entire cohort was 45.7 mos; 84.7% of the pts were alive at the last follow up. ISS stage distribution included: Stage 1 (35.3%), Stage II (38.9%) and stage III (25.8%). The distribution of FISH abnormalities included: del 13q (14.5%), 1q amp (12.1%), del 17p or monosomy 17 (6.1%). Pts received initial therapy with different regimens: IMiD-24.3%, PI-41.0%, both-20.8% and 13.8% had no novel agent. The drug classes by line of therapy are shown in table. An early stem cell transplant (SCT) was used in 40.8% of pts. The median time to next treatment (TTNT) after initial treatment was 15.0 (95% CI: 12.2 to 17.7) mos. The median overall survival from diagnosis for the entire cohort was 82.5 (95% CI: 73.5 to 95.8) mos. Conclusions: This is the first study to examine the outcomes of a large group of myeloma pts with t(11;14) abnormality. Pts receiving a combination if a PI and an IMiD appear to have the best survival outcomes and thse receiving an early SCT appear to have excellent survival with median OS approaching 10 years. Additional pts are being accrued to this study and additional analysis examining the variables affecting response duration and survival will be presented.

Number (%) of pts in regimen category by line of therapy.

Regimen typeLine 1Line 2Line 3
IMiD139 (24.3%)139 (37.7%)124 (44.4%)
PI234 (41.0%)144 (39.0%)86 (30.8%)
IMiD and PI119 (20.8%)48(13.0%)16 ( 5.7%)
Other79 (13.8%)38 (10.3%)53 (19.0%)
Number of pts571369279

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Abstract Details

Meeting

2019 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies—Plasma Cell Dyscrasia

Sub Track

Multiple Myeloma

Citation

J Clin Oncol 37, 2019 (suppl; abstr 8015)

DOI

10.1200/JCO.2019.37.15_suppl.8015

Abstract #

8015

Poster Bd #

341

Abstract Disclosures