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Mian M, Tinelli M, DE March E, Turri G, Meneghini V, Pescosta N, Berno T, Marabese A, Mondello P, Patriarca F, Pizzolo G, Semenzato G, Cortelazzo S, Zambello R. Bortezomib, Thalidomide and Lenalidomide: Have They Really Changed the Outcome of Multiple Myeloma? Anticancer Res 2016; 36:1059-1065. [PMID: 26976998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Treatment of multiple myeloma (MM) has significantly improved, although the disease remains incurable. Prospective clinical trials evaluating the impact on outcome of new drugs such as proteasome inhibitors or immunomodulating agents are limited since they are not able to reflect the clinical routine and available retrospective data are not detailed enough to directly evaluate the value of new drugs. To address these information gaps, we performed a retrospective real-life analysis. We retrospectively assessed 949 patients treated for multiple myeloma or plasma cell leukemia at three Italian cancer centers in the years 1979-2014. Clinical features at the time of diagnosis were consistent with what was observed in clinical routine. A total of 39% of patients underwent high-dose chemotherapy followed by autologous stem cell transplantation (ASCT). The median overall survival (OS) of the whole group was 5.4 years and ranged from 3.4 years for patients who did not receive at least one of the new drugs compared to 5.9 years in the other patients (p<0.001). The improvement in OS due to administration of new drugs was also observed among different prognostic sub-groups such as age, Durie and Salmon stage, international staging system and renal impairment. Availability of new drugs significantly improved survival of patients who underwent ASCT and also those who did not. In conclusion, we provided evidence that the advent of the new drugs drastically improved the outcome of patients with MM, also in cases with poor risk at the time of diagnosis. ASCT is still of major importance in the treatment of this disease. Nevertheless, MM remains incurable and new therapeutic approaches are warranted.
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Affiliation(s)
- Michael Mian
- Department of Hematology & Center of Bone Marrow Transplantation, Ospedale di Bolzano, Bolzano, Italy Department of Internal Medicine V (Haematology and Oncology), Medical University of Innsbruck, Innsbruck, Austria
| | - Martina Tinelli
- Department of Medicine, Section of Hematology, University Hospital of Verona, Verona, Italy
| | - Elena DE March
- Department of Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
| | - Gloria Turri
- Department of Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
| | - Vittorio Meneghini
- Department of Medicine, Section of Hematology, University Hospital of Verona, Verona, Italy
| | - Norbert Pescosta
- Department of Hematology & Center of Bone Marrow Transplantation, Ospedale di Bolzano, Bolzano, Italy
| | - Tamara Berno
- Department of Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
| | - Alessandra Marabese
- Department of Hematology & Center of Bone Marrow Transplantation, Ospedale di Bolzano, Bolzano, Italy
| | - Patrizia Mondello
- Department of Human Pathology, University of Messina, Messina, Italy
| | | | - Giovanni Pizzolo
- Department of Medicine, Section of Hematology, University Hospital of Verona, Verona, Italy
| | - Gianpietro Semenzato
- Department of Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
| | - Sergio Cortelazzo
- Unit of Medical Oncology and Hematology, Clinical Institute Humanitas-Gavazzeni, Bergamo, Italy
| | - Renato Zambello
- Department of Medicine, Hematology and Clinical Immunology, Padua University School of Medicine, Padua, Italy
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