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Ghermezi M, Li M, Vardanyan S, Harutyunyan NM, Gottlieb J, Berenson A, Spektor TM, Andreu-Vieyra C, Petraki S, Sanchez E, Udd K, Wang CS, Swift RA, Chen H, Berenson JR. Serum B-cell maturation antigen: a novel biomarker to predict outcomes for multiple myeloma patients. Haematologica 2017; 102:785-795. [PMID: 28034989 PMCID: PMC5395119 DOI: 10.3324/haematol.2016.150896] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 12/22/2016] [Indexed: 11/26/2022] Open
Abstract
B-cell maturation antigen is expressed on plasma cells. In this study, we have identified serum B-cell maturation antigen as a novel biomarker that can monitor and predict outcomes for multiple myeloma patients. Compared to healthy donors, patients with multiple myeloma showed elevated serum B-cell maturation antigen levels (P<0.0001). Serum B-cell maturation antigen levels correlated with the proportion of plasma cells in bone marrow biopsies (Spearman's rho = 0.710; P<0.001), clinical status (complete response vs partial response, P=0.0374; complete response vs progressive disease, P<0.0001), and tracked with changes in M-protein levels. Among patients with non-secretory disease, serum B-cell maturation antigen levels correlated with bone marrow plasma cell levels and findings from positron emission tomography scans. Kaplan-Meier analysis demonstrated that serum B-cell maturation antigen levels above the median levels were predictive of a shorter progression-free survival (P=0.0006) and overall survival (P=0.0108) among multiple myeloma patients (n=243). Specifically, patients with serum B-cell maturation antigen levels above the median level at the time of starting front-line (P=0.0043) or a new salvage therapy (P=0.0044) were found to have shorter progression-free survival. Importantly, serum B-cell maturation antigen levels did not show any dependence on renal function and maintained independent significance when tested against other known prognostic markers for multiple myeloma such as age, serum β2 microglobulin, hemoglobin, and bone disease. These data identify serum B-cell maturation antigen as a new biomarker to manage multiple myeloma patients.
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Affiliation(s)
- Michael Ghermezi
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - Mingjie Li
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - Suzie Vardanyan
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | | | - Jillian Gottlieb
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - Ariana Berenson
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | | | | | | | - Eric Sanchez
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - Kyle Udd
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - Cathy S Wang
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | | | - Haiming Chen
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
| | - James R Berenson
- Institute for Myeloma & Bone Cancer Research, West Hollywood, CA, USA
- Oncotherapeutics, West Hollywood, CA, USA
- James R. Berenson, MD, Inc., West Hollywood, CA, USA
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Berenson A, Vardanyan S, David M, Wang J, Harutyunyan NM, Gottlieb J, Halleluyan R, Spektor TM, Udd KA, Eshaghian S, Nassir Y, Eades B, Swift R, Berenson JR. Outcomes of multiple myeloma patients receiving bortezomib, lenalidomide, and carfilzomib. Ann Hematol 2016; 96:449-459. [PMID: 27933373 DOI: 10.1007/s00277-016-2889-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 11/27/2016] [Indexed: 12/13/2022]
Abstract
New classes of drugs including the proteasome inhibitors (PI) bortezomib and, more recently, carfilzomib and the immunomodulatory agent lenalidomide have shown improved outcomes for multiple myeloma (MM) patients during the past decade. However, most of the studies reporting outcomes for patients receiving these drugs have relied on older data sets derived from large institutions that included patients not receiving their treatment at those facilities and represented only those eligible for clinical trials or were from sites where treatment options were limited. We have analyzed data from 258 MM patients who have received treatment with at least one of three agents: bortezomib, carfilzomib, and lenalidomide in a single clinic specializing in MM with respect to their responses and other outcomes to treatment regimens including these agents. Response rates were similar between these three drugs when used for the first time and again during subsequent treatment regimens. As expected, the clinical benefit rates (CBRs) were better for patients receiving their first treatment when compared to their use in subsequent treatment regimens. The CBRs were similar during their 2nd, 3rd, and 4th treatments containing these agents. Many patients refractory to these agents showed responses to regimens containing these same drugs when used in different combinations. In addition, patients refractory to one PI often responded to the other PI. The results of this study demonstrate that novel agents can be used repeatedly in novel combinations with significant clinical benefit for patients with MM.
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Affiliation(s)
- Ariana Berenson
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Suzie Vardanyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Michael David
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - James Wang
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA
| | - Nika Manik Harutyunyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Jillian Gottlieb
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Ran Halleluyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Tanya M Spektor
- Oncotherapeutic, 9201 W. Sunset Blvd., Suite 317, West Hollywood, CA, USA
| | - Kyle A Udd
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA
| | - Shahrooz Eshaghian
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Youram Nassir
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA
| | - Benjamin Eades
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA
| | - Regina Swift
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA
| | - James R Berenson
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA.
- James R. Berenson, MD, Inc., 9201 W. Sunset Blvd., Suite 310, West Hollywood, CA, USA.
- Oncotherapeutic, 9201 W. Sunset Blvd., Suite 317, West Hollywood, CA, USA.
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Berenson A, Vardanyan S, David M, Wang J, Harutyunyan NM, Gottlieb J, Halleluyan R, Spektor TM, Udd KA, Eshaghian S, Nassir Y, Eades B, Swift R, Berenson JR. Improved clinical outcomes for multiple myeloma patients treated at a single specialty clinic. Ann Hematol 2016; 96:441-448. [PMID: 27913860 DOI: 10.1007/s00277-016-2888-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 11/27/2016] [Indexed: 10/20/2022]
Abstract
Despite recent advances made in its treatment, multiple myeloma (MM) remains an incurable B cell malignancy. Thus, the objective for treating these patients is to prolong overall survival (OS) and preserve patients' quality of life. We have analyzed data from 264 consecutive MM patients who had their initial visit between July 1, 2004 and December 1, 2014 and have received treatment in a single clinic specializing in MM. We determined their progression-free survival (PFS, OS, and 5-year OS). The PFS for frontline (n = 165 treatments), salvage (n = 980), and all treatments (n = 1145) were 13.9, 4.6, and 5.5 months, respectively. The median OS of all patients was 98 months with a 5-year survival of 74%. The results of this study show a marked improvement in OS for unselected MM patients compared with historical data. There were no significant differences in OS between patients with different International Staging System (ISS) stages. Younger patients (<65 years old) showed a longer OS. The results of this study should help physicians predict outcomes for MM patients and be encouraging for patients with this B cell malignancy.
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Affiliation(s)
- Ariana Berenson
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Suzie Vardanyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Michael David
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - James Wang
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA.,James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA
| | - Nika Manik Harutyunyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Jillian Gottlieb
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Ran Halleluyan
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Tanya M Spektor
- Oncotherapeutics, 9201 W. Sunset Blvd, Suite 317, West Hollywood, CA, USA
| | - Kyle A Udd
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA.,James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA
| | - Shahrooz Eshaghian
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA
| | - Youram Nassir
- James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA
| | - Benjamin Eades
- James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA
| | - Regina Swift
- James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA
| | - James R Berenson
- Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd., Suite 300, West Hollywood, CA, 90069, USA. .,James R. Berenson, MD, Inc., Institute for Myeloma & Bone Cancer Research, 9201 W. Sunset Blvd, Suite 310, West Hollywood, CA, USA. .,Oncotherapeutics, 9201 W. Sunset Blvd, Suite 317, West Hollywood, CA, USA.
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Sanchez E, Gillespie A, Tang G, Ferros M, Harutyunyan NM, Vardanyan S, Gottlieb J, Li M, Wang CS, Chen H, Berenson JR. Soluble B-Cell Maturation Antigen Mediates Tumor-Induced Immune Deficiency in Multiple Myeloma. Clin Cancer Res 2016; 22:3383-97. [PMID: 26960399 DOI: 10.1158/1078-0432.ccr-15-2224] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 02/23/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Eric Sanchez
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Abigail Gillespie
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - George Tang
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Morgan Ferros
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | | | - Suzie Vardanyan
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Jillian Gottlieb
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Mingjie Li
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Cathy S Wang
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - Haiming Chen
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California
| | - James R Berenson
- Institute for Myeloma and Bone Cancer Research, West Hollywood, California.
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