Several parameters were associated with early, deep response to treatment, revealing distinct sets of predictors for immunomodulator- and proteasome-inhibitor-containing regimens, according to a study of 1,304 patients with newly diagnosed multiple myeloma. Researchers found:

•An increased odds ratio (OR) of achieving a very good partial response or better (VGPR+) after 4 cycles was associated with:

• greater absolute free light chain (FLC) differences (OR 2.38)
• younger age (OR 2.18)
• lower hemoglobin (OR 1.68)
• IgA myeloma (OR 1.66)

•Among patients receiving novel agents in general and immunomodulators in particular, these effects were more pronounced.

•In patients receiving proteasome inhibitors, better responses were associated with:

• higher creatinine (OR 3.83)
• lower calcium (OR 3.37)
• greater absolute FLC differences (OR 2.50)

•Achieving VGPR+ after 4 cycles translated into increased overall survival.

Citation: Binder M, Rajkumar SV, Gertz MA, et al. Predictors of early response to initial therapy in patients with newly diagnosed symptomatic multiple myeloma. [Published online ahead of print July 6, 2015]. Am J Hematol. doi: 10.1002/ajh.24107.