Multiple myeloma—better drugs ask for more stringent evaluations
Mené sur 45 patients atteints d'un myélome multiple récemment diagnostiqué et sur 12 patients atteints d'un myélome multiple asymptomatique à haut risque, cet essai évalue l'efficacité, du point de vue du taux de réponse partielle, et la toxicité (neuropathie de grade égal ou supérieur à 3) d'un traitement combinant carfilzomib, lénadomide et dexaméthasone
In this issue of JAMA Oncology, Korde and colleagues report an elegant pilot study of carfilzomib combined with lenalidomide and dexamethasone (CRd) for 45 patients with newly diagnosed multiple myeloma (NDMM). Their study renders 3 important conclusions that are a prelude to the future of myeloma treatment. First, with this combination of effective and well-tolerated drugs, more and deep responses can be achieved across different prognostic subgroups defined by fluorescent in situ hybridization (FISH). Second, the level of tumor reduction goes beyond morphological complete response (CR) as is shown by serial measurements of minimal residual disease (MRD). In addition, in a group of 12 patients with high-risk but asymptomatic smoldering multiple myeloma, substantial disease eradication was observed, resulting in MRD negativity in all patients. Finally, this study is an example of informative clinical research.
JAMA Oncology , commentaire, 2014