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32 results on '"Rodriguez-Otero P."'

1. Immunogenomic identification and characterization of granulocytic myeloid-derived suppressor cells in multiple myeloma

Author

Perez C., Botta C., Zabaleta A., Puig N., Cedena M. -T., Goicoechea I., Alameda D., Jose-Eneriz E. S., Merino J., Rodriguez-Otero P., Maia C., Alignani D., Maiso P., Manrique I., Lara-Astiaso D., Vilas-Zornoza A., Sarvide S., Riillo C., Rossi M., Rosinol L., Oriol A., Blanchard M. -J., Rios R., Sureda A., Martin J., Martinez R., Bargay J., de la Rubia J., Hernandez M. -T., Martinez-Lopez J., Orfao A., Agirre X., Prosper F., Mateos M. -V., Lahuerta J. -J., Blade J., San-Miguel J. F., Paiva B., Espinosa M. C., Zamudio J. L. G., Herranz E. R., Tamayo R. R., Sanchez J. M., Bernal L. P., Rodriguez A. P. G., Garcia M. E. G., Mayol A. S., Lleonart J. B., Suarez A., Garcia M. T. H., Gaisan C. M., Ruiz B. H., Montero F. C., de Miguel Llorente D., Ramos F. S., Garcia A. I., Manteca M. M., Martin J. M. H., Barrigon F. E., Frade J. G., de Coca A. G., Franco C. A., Gomez J. L., Perez E. C., Creixenti J. B., Balari A. M. S., Montes Y. G., Teigell L. E., Guinon A. G., Monreal E. A., Campos J. A. S., Tutusaus J. M. M., Rocafiguera A. O., Gorrochategui M. G., Mesa M. G., Silva C. C., Perez M. S. G., Loureiro A. D., Sanchez J. A. M., Irazu M. J. N., Parraga F. J. P., Palacios J. J. L., Barahona P. B., Rodriguez C. E., Rivas J. A. H., de Oteyza J. P., del Barrio R. I., de la Guia A. L., Amor A. A., Pareja E. P., Castello I. K., Rodriguez M. J. B., Martinez R. M., Grau R. R., Mesa E. G., Sainz E. R., de Arriba F., Jimenez J. M. M., Romera M., Cardoso F. P., Perez J. M. A., Pomposo M. P., Persona E. P., Casasus A. I. T., Garcia P. R., Ramos I. J., Lor M. B. V., Garcia P. L. F., Chamorro C. M., Perez C., Botta C., Zabaleta A., Puig N., Cedena M.-T., Goicoechea I., Alameda D., Jose-Eneriz E.S., Merino J., Rodriguez-Otero P., Maia C., Alignani D., Maiso P., Manrique I., Lara-Astiaso D., Vilas-Zornoza A., Sarvide S., Riillo C., Rossi M., Rosinol L., Oriol A., Blanchard M.-J., Rios R., Sureda A., Martin J., Martinez R., Bargay J., de la Rubia J., Hernandez M.-T., Martinez-Lopez J., Orfao A., Agirre X., Prosper F., Mateos M.-V., Lahuerta J.-J., Blade J., San-Miguel J.F., Paiva B., Espinosa M.C., Zamudio J.L.G., Herranz E.R., Tamayo R.R., Sanchez J.M., Bernal L.P., Rodriguez A.P.G., Garcia M.E.G., Mayol A.S., Lleonart J.B., Suarez A., Garcia M.T.H., Gaisan C.M., Ruiz B.H., Montero F.C., de Miguel Llorente D., Ramos F.S., Garcia A.I., Manteca M.M., Martin J.M.H., Barrigon F.E., Frade J.G., de Coca A.G., Franco C.A., Gomez J.L., Perez E.C., Creixenti J.B., Balari A.M.S., Montes Y.G., Teigell L.E., Guinon A.G., Monreal E.A., Campos J.A.S., Tutusaus J.M.M., Rocafiguera A.O., Gorrochategui M.G., Mesa M.G., Silva C.C., Perez M.S.G., Loureiro A.D., Sanchez J.A.M., Irazu M.J.N., Parraga F.J.P., Palacios J.J.L., Barahona P.B., Rodriguez C.E., Rivas J.A.H., de Oteyza J.P., del Barrio R.I., de la Guia A.L., Amor A.A., Pareja E.P., Castello I.K., Rodriguez M.J.B., Martinez R.M., Grau R.R., Mesa E.G., Sainz E.R., de Arriba F., Jimenez J.M.M., Romera M., Cardoso F.P., Perez J.M.A., Pomposo M.P., Persona E.P., Casasus A.I.T., Garcia P.R., Ramos I.J., Lor M.B.V., Garcia P.L.F., and Chamorro C.M.

Subjects
Male, Transcription, Genetic, Neutrophils, T-Lymphocytes, Immunology, CD33, Biology, CD16, Biochemistry, Follow-Up Studie, Flow cytometry, Antigens, CD, medicine, Humans, Cytotoxic T cell, Lymphocyte Count, Tumor microenvironment, medicine.diagnostic_test, Myeloid-Derived Suppressor Cells, Cell Biology, Hematology, Middle Aged, Cell sorting, Neoplasm Proteins, medicine.anatomical_structure, T-Lymphocyte, Cancer research, Myeloid-derived Suppressor Cell, Female, Bone marrow, Multiple Myeloma, Human, Follow-Up Studies
Abstract

Granulocytic myeloid-derived suppressor cells (G-MDSCs) promote tumor growth and immunosuppression in multiple myeloma (MM). However, their phenotype is not well established for accurate monitoring or clinical translation. We aimed to provide the phenotypic profile of G-MDSCs based on their prognostic significance in MM, immunosuppressive potential, and molecular program. The preestablished phenotype of G-MDSCs was evaluated in bone marrow samples from controls and MM patients using multidimensional flow cytometry; surprisingly, we found that CD11b+CD14−CD15+CD33+HLADR− cells overlapped with common eosinophils and neutrophils, which were not expanded in MM patients. Therefore, we relied on automated clustering to unbiasedly identify all granulocytic subsets in the tumor microenvironment: basophils, eosinophils, and immature, intermediate, and mature neutrophils. In a series of 267 newly diagnosed MM patients (GEM2012MENOS65 trial), only the frequency of mature neutrophils at diagnosis was significantly associated with patient outcome, and a high mature neutrophil/T-cell ratio resulted in inferior progression-free survival (P < .001). Upon fluorescence-activated cell sorting of each neutrophil subset, T-cell proliferation decreased in the presence of mature neutrophils (0.5-fold; P = .016), and the cytotoxic potential of T cells engaged by a BCMA×CD3-bispecific antibody increased notably with the depletion of mature neutrophils (fourfold; P = .0007). Most interestingly, RNA sequencing of the 3 subsets revealed that G-MDSC–related genes were specifically upregulated in mature neutrophils from MM patients vs controls because of differential chromatin accessibility. Taken together, our results establish a correlation between the clinical significance, immunosuppressive potential, and transcriptional network of well-defined neutrophil subsets, providing for the first time a set of optimal markers (CD11b/CD13/CD16) for accurate monitoring of G-MDSCs in MM.

Published
2020

2. 11C-methionine PET/CT in assessment of multiple myeloma patients: comparison to 18F-FDG PET/CT and prognostic value evaluation

Author

Morales-Lozano, M. I. (Mª Isabel), Rodriguez-Otero, P. (Paula), Sancho-Rodriguez, L. (Lidia), Nuñez-Cordoba, J.M. (Jorge M.), Prieto-Azcárate, E. (Elena), Marcos-Jubilar, M. (María), Rosales, J.J. (Juan José), Alfonso-Piérola, A. (Ana), Guillén-Valderrama, E.F. (Edgar Fernando), San-Miguel, J.F. (Jesús F.), and Garcia-Velloso, M. J. (María José)

Subjects
18F-FDG, TLMU, Positron emission tomography, TLG, Multiple myeloma, PET/CT, 11C-methionine, Prognosis, TMTV, Volume-based parameters
Abstract

Multiple myeloma (MM) is the second most common haematological malignancy and remains incurable despite therapeutic advances. 18F-FDG (FDG) PET/CT is a relevant tool MM for staging and it is the reference imaging technique for treatment evaluation. However, it has limitations, and investigation of other PET tracers is required. Preliminary results with L-methyl-[11C]- methionine (MET), suggest higher sensitivity than 18F-FDG. This study aimed to compare the diagnostic accuracy and prognostic value of 1FDG and MET in MM patients. We prospectively compared FDG and MET PET/CT for assessment of bone disease and extramedullary disease (EMD) in a series of 52 consecutive patients (8 smoldering MM, 18 newly diagnosed MM and 26 relapsed MM patients). Bone marrow (BM) uptake patterns and the detection of focal lesions (FLs) and EMD were compared. Furthermore, FDG PET parameters with known MM prognostic value were explored for both tracers, as well as total lesion MET uptake (TLMU). Median patient age was 61 years (range, 37-83 years), 54% were male, 13% of them were in stage ISS (International Staging System) III, and 31% had high-risk cytogenetics. FDG PET/CT did not detect active disease in 6 patients, while they were shown to be positive by MET PET/CT. Additionally, MET PET/CT identified a higher number of FLs than FDG in more than half of the patients (63%). For prognostication we focussed on the relapsed cohort, due to the low number of progressions in the two other cohorts. Upon using FDG PET/CT in relapsed patients, the presence of more than 3 FLs (HR 4.61, p = 0.056), more than 10 FLs (HR 5.65, p = 0.013), total metabolic tumor volume (TMTV) p50 (HR 4.91, p = 0.049) or TMTV p75 (HR 5.32, p = 0.016) were associated with adverse prognosis. In MET PET/CT analysis, TMTV p50 (HR 4.71, p = 0.056), TMTV p75 (HR 6.27, p = 0.007), TLMU p50 (HR 8.8, p = 0.04) and TLMU p75 (HR 6.3, p = 0.007) adversely affected PFS. This study confirmed the diagnostic and prognostic value of FDG in MM. In addition, it highlights that MET has higher sensitivity than FDG PET/CT for detection of myeloma lesions, including FLs. Moreover, we show, for the first time, the prognostic value of TMTV and TLMU MET PET/CT in the imaging evaluation of MM patients.

Published
2022

3. HORIZON (OP-106): Melflufen Plus Dexamethasone (dex) in 55 Patients (pts) with Relapsed/Refractory Multiple Myeloma (RRMM) with Extramedullary Disease (EMD)-Subgroup Analysis

Author

Zamagni, E, Richardson, PG, Mateos, MV, Oriol, A, Larocca, A, Cavo, M, Rodriguez-Otero, P, Leleu, X, Norkin, M, Nadeem, O, Hiemenz, JW, Hassoun, H, Touzeau, C, Alegre, A, Paner, A, Maisel, C, Mazumder, A, Raptis, A, Puig, N, Thuresson, M, Harmenberg, J, Harlin, O, and Blade, J

Subjects
Immunology, Cell Biology, Hematology, Biochemistry
Abstract

Background: EMD is characterized by a subclone of aggressive MM cells that thrive and grow independent of the bone marrow microenvironment and is often associated with poor-risk features including high-risk cytogenetics, increased proliferation, evasion of apoptosis, and resistance to therapies in MM (Bladé et al. J Clin Oncol. 2011;29:3805; Deng et al. Clin Lymphoma Myeloma Leuk. 2015;15:286). Prognosis for pts with EMD is poor, particularly in the RRMM setting. Additionally, prognosis is usually poorer for pts with hematogenous-spread soft-tissue plasmacytomas than for those with bone-related plasmacytomas (Gagelmann et al. Haematologica. 2018;103:890; Mangiacavalli et al. Ann Hematol. 2017;96:73). No standard therapy has been established for this high-unmet need population (Usmani et al. Blood. 2016;128:37; Jimenez-Segura et al. Eur J Haematol. 2019;102:389), and outcomes are considerably worse than those for pts without EMD; for example, a recent analysis of isatuximab + pomalidomide + dex showed a median progression free survival (PFS) of 4.6 mo vs 11.5 mo in the total population (Beksac et al. EHA 2020. Abs. EP978). Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate (PDC) that targets aminopeptidases and rapidly releases alkylating agents into tumor cells. In the phase 2 HORIZON study (OP-106; NCT02963493), melflufen + dex showed clinically meaningful efficacy (overall response rate [ORR], 29%; median PFS, 4.2 mo; median overall survival [OS], 11.6 mo) and a manageable safety profile in pts with heavily pretreated RRMM, including in pts with triple-class-refractory MM (Richardson et al. EHA 2020. Abs. EP945). This analysis presents additional data for the largest cohort of pts with EMD in a clinical trial setting to date. Methods: Pts with RRMM must have received ≥2 lines of prior therapy, including an IMiD and a proteasome inhibitor, and been refractory to pomalidomide and/or an anti-CD38 monoclonal antibody. Pts received melflufen 40 mg (intravenous; d1 of each 28-d cycle) and dex 40 mg/wk until progressive disease or unacceptable toxicity. The primary endpoint was ORR (≥ partial response [PR]; investigator-assessed per International Myeloma Working Group [IMWG] criteria). Secondary endpoints included PFS, OS, duration of response (DOR), and safety. For pts with known or suspected EMD, defined as either isolated soft-tissue and/or bone-related extramedullary plasmacytomas with soft-tissue extension, an assessment was required at screening and to confirm a response per IMWG criteria. Results: Of 157 pts enrolled and treated (data cutoff date, Jan 14, 2020), 55 (35%) had EMD (49% soft-tissue and 51% bone-related soft-tissue plasmacytoma). In pts with EMD, median age was 64 y (range, 43-82); median time since diagnosis was 5.6 y (range, 0.7-14.5); 35% had high-risk cytogenetics; 33% had International Staging System stage 3; median prior lines of therapy was 5 (range, 2-12); 60% had disease that was refractory to prior alkylator therapy; and 91% had triple-class-refractory MM. ORR (95% CI) was 24% (13-37) in pts with EMD and 29% (22-37) overall (N=157). In pts with EMD and the overall population, respectively, median (95% CI) DOR was 5.5 mo (1.8-not evaluable [NE]) and 5.5 mo (3.9-7.6), PFS was 2.9 mo (2.0-3.8) and 4.2 mo (3.4-4.9), and median OS was 6.5 mo (5.1-9.7) and 11.6 mo (9.3-15.4;) (Table). In pts with EMD who achieved ≥PR (n=13), median (95% CI) PFS was 17.3 mo (5.3-NE), and OS was 18.5 mo (8.7-NE). Due to low event numbers, the results in pts with ≥PR may be overestimated. The safety profile of melflufen + dex in pts with EMD was consistent with that in the overall population, with grade 3/4 treatment-emergent adverse events (TEAEs) reported in 78% and 89% of pts, respectively. In pts with EMD, the most common grade 3/4 TEAEs were anemia (42%), thrombocytopenia (40%), and neutropenia (38%); the most common nonhematologic grade 3/4 TEAE of interest was pneumonia (9%). No treatment-related deaths with melflufen + dex were reported. Conclusions: Melflufen + dex showed activity in advanced RRMM with EMD, with encouraging PFS and OS in pts with confirmed stable disease or better. The safety profile of melflufen + dex was consistent with previous reports. To date, this clinical study provides the largest cohort of pts with EMD demonstrating benefit in this population with a high unmet medical need. These data support further evaluation of melflufen + dex in RRMM with EMD. Disclosures Richardson: Celgene/BMS, Oncopeptides, Takeda, Karyopharm: Research Funding. Mateos:AbbVie: Honoraria, Membership on an entity's Board of Directors or advisory committees; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Adaptive: Honoraria, Membership on an entity's Board of Directors or advisory committees; GlaxoSmithKline: Honoraria; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees; Seattle Genetics: Honoraria, Membership on an entity's Board of Directors or advisory committees; Roche: Honoraria, Membership on an entity's Board of Directors or advisory committees; Oncopeptides: Honoraria, Membership on an entity's Board of Directors or advisory committees; Takeda: Honoraria, Membership on an entity's Board of Directors or advisory committees; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees; Regeneron: Honoraria, Membership on an entity's Board of Directors or advisory committees. Oriol:Janssen: Consultancy; GlaxoSmithKline: Membership on an entity's Board of Directors or advisory committees; Sanofi: Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Speakers Bureau; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Larocca:Amgen: Honoraria; Bristol-Myers Squibb: Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees; GSK: Honoraria; Takeda: Membership on an entity's Board of Directors or advisory committees. Cavo:AbbVie: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel accomodations, Speakers Bureau; Janssen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel accomodations, Speakers Bureau; GlaxoSmithKline: Honoraria, Speakers Bureau; Karyopharm: Honoraria; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Amgen: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Novartis: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Rodríguez-Otero:Abbvie: Consultancy; Oncopeptides: Consultancy; Medscape: Membership on an entity's Board of Directors or advisory committees; Celgene/Bristol Myers Squibb: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); Janssen: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES (paid by any for-profit health care company); Amgen: Honoraria; GlaxoSmithKline: Consultancy, Current Employment, Current equity holder in publicly-traded company; Kite: Consultancy; Sanofi: Consultancy. Leleu:AbbVie: Honoraria; Carsgen: Honoraria; Incyte: Honoraria; Merck: Honoraria; Oncopeptide: Honoraria; Karyopharm: Honoraria; Sanofi: Honoraria; GSK: Honoraria; Amgen: Honoraria; Novartis: Honoraria; BMS-celgene: Honoraria; Janssen: Honoraria. Nadeem:Amgen: Membership on an entity's Board of Directors or advisory committees; Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees; Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: TRAVEL, ACCOMMODATIONS, EXPENSES; Adaptive: Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES. Hassoun:Takeda: Research Funding; Celgene: Research Funding; Novartis: Consultancy. Touzeau:Abbvie: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses, Research Funding; Sanofi: Honoraria, Research Funding; Takeda: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses; Amgen: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses; Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees; Janssen: Consultancy, Honoraria, Other: Travel, Accommodations, Expenses; GlaxoSmithKline: Honoraria, Research Funding. Amor:GSK: Membership on an entity's Board of Directors or advisory committees; Takeda: Membership on an entity's Board of Directors or advisory committees; Amgen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding; Celgene-BMS: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Janssen: Consultancy, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Sanofi: Consultancy, Membership on an entity's Board of Directors or advisory committees. Maisel:Texas Oncology: Current Employment; Amgen: Honoraria, Speakers Bureau; Kite: Honoraria, Speakers Bureau; Celgene: Honoraria, Speakers Bureau; Incyte: Honoraria, Speakers Bureau; Karyopharm: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Takeda: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Celgene: Honoraria, Speakers Bureau; Texas Oncology: Current Employment; Kite: Honoraria, Speakers Bureau; Incyte: Honoraria, Speakers Bureau; Karyopharm: Honoraria, Speakers Bureau; Takeda: Honoraria, Speakers Bureau; Amgen: Honoraria, Speakers Bureau. Mazumder:Amgen: Honoraria, Speakers Bureau; Celgene: Honoraria, Speakers Bureau; Takeda: Honoraria, Speakers Bureau; The Oncology Institute: Current Employment. Raptis:UPMC: Current Employment; INTEGRA: Consultancy, Other: TRAVEL, ACCOMMODATIONS, EXPENSES. Puig:THE BINDING SITE: Consultancy, Honoraria; TAKEDA: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Research Funding; JANSSEN: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Research Funding; BRISTOL-MYERS SQUIBB: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Research Funding, Speakers Bureau; CELGENE: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Research Funding, Speakers Bureau; AMGEN: Consultancy, Honoraria, Other: TRAVEL, ACCOMMODATIONS, EXPENSES, Research Funding. Zamagni:Janssen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses, Speakers Bureau; Takeda: Honoraria, Other: Travel, Accommodations, Expenses, Speakers Bureau; BMS: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses, Speakers Bureau; Amgen: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sanofi: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Travel, Accommodations, Expenses, Speakers Bureau; Celgene Corporation: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Thuresson:Oncopeptides: Consultancy, Current equity holder in publicly-traded company; Statisticon: Current Employment. Harmenberg:Ultupharma AB: Current equity holder in private company; Medivir AB: Current equity holder in publicly-traded company; Oncopeptides AB: Consultancy, Current equity holder in publicly-traded company, Divested equity in a private or publicly-traded company in the past 24 months, Other: TRAVEL, ACCOMMODATIONS, EXPENSES. Harlin:Oncopeptides AB: Consultancy, Current equity holder in publicly-traded company. Blade Creixenti:Takeda: Membership on an entity's Board of Directors or advisory committees; Oncopeptides: Membership on an entity's Board of Directors or advisory committees; Celgene: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Janssen: Membership on an entity's Board of Directors or advisory committees. OffLabel Disclosure: This is a phase 2 investigational study of melflufen in RRMM.

Published
2020

4. HORIZON (OP-106): Melflufen Plus Dexamethasone in 55 Patients with Relapsed/Refractory Multiple Myeloma (RRMM) with Extramedullary Disease (EMD): Subgroup Analysis

Author

Richardson, PG, Mateos, MV, Oriol, A, Larocca, A, Cavo, M, Rodriguez-Otero, P, Leleu, X, Norkin, M, Nadeem, O, Hiemenz, JW, Hassoun, H, Touzeau, C, Alegre, A, Paner, A, Maisel, C, Mazumder, A, Raptis, A, Puig, N, Zamagni, E, Thuresson, M, Harmenberg, J, Harlin, O, and Blade, J

Subjects
multiple myeloma, peptide-drug conjugate, extramedullary disease, MM, melphalan flufenamide, melflufen
Published
2021

8. Pomalidomide, Cyclophosphamide, and Dexamethasone for the Treatment of Relapsed/ Refractory Multiple Myeloma: Real-World Analysis of the Pethema-GEM Experience

Author

Rodriguez-Otero P, Sirvent M, González-Rodríguez AP, Lavilla E, de Coca AG, Arguiñano JM, Martí JM, Cabañas V, Motlló C, de Cabo E, Encinas C, Murillo I, Hernández-Rivas JÁ, Pérez-Persona E, Casado F, Sampol A, García R, Blanchard MJ, Anguita M, Lafuente AP, Iñigo B, López A, Ribas P, Arnao M, Maldonado R, Bladé J, Mateos MV, Lahuerta JJ, and San Miguel JF

Subjects
Refractory multiple myeloma, Triplet therapy, Pomalidomide, Real-world study, Lenalidomide-refractoriness
Abstract

Treatment of relapsed/refractory multiple myeloma (RRMM) is highly challenging. We analyzed the efficacy and safety of pomalidomide, cyclophosphamide, and dexamethasone (PomCiDex) in a real-world RRMM population. Median progression-free and overall survival were 7.6 and 12.6 months, respectively, which compares favorably with other triplets in the same setting. PomCiDex remains a manageable, cost-effective, and all-oral triplet combination for RRMM. Introduction: Treatment of relapsed/refractory multiple myeloma (RRMM) is highly challenging, especially for patients with disease refractory to initial therapy, and in particular for disease developing refractoriness to lenalidomide. Indeed, with currently approved treatments, median progression-free survival (PFS) in the lenalidomide-refractory setting is less than 10 months, reflecting the difficulty in treating this patient population. Pomalidomide is a second-generation immunomodulatory drug that has shown activity in lenalidomide-refractory disease in the setting of different combinations. Patients and Methods: A real-world study was conducted by the Spanish Myeloma group in a cohort of patients with RRMM treated with pomalidomide, cyclophosphamide, and dexamethasone (PomCiDex). One hundred patients were treated with a median of 3 prior lines of therapy. Results: Overall response rate was 39%, with a clinical benefit rate of 93%. Median PFS was 7.6 months; median overall survival (OS) was 12.6 months. Median PFS and OS survival were consistent across the different subgroups analyzed. Prolonged PFS and OS were found in patients with responsive disease. Conclusion: Our results compared favorably with those obtained with different pomalidomide-based combinations in a similar patient population. PomCiDex remains a manageable, cost-effective, and all-oral triplet combination for RRMM patients. (C) 2021 Published by Elsevier Inc.

Published
2021

11. Subcutaneous Daratumumab (DARA SC) with Standard-ofCare (SoC) in Multiple Myeloma (MM) across therapy lines in phase 2 PLEIADES: Initial results with SoC Carfilzomib/Dexamethasone (D-Kd) and updated results with SoC Bortezomib/Melphalan/Prednisone (D-VMP) or Lenalidomide/Dexamethasone (D-Rd)

Author

Goldschmidt, H, Chari, A, Haenel, M, Oriol, A, Rodriguez-Otero, P, McCarthy, H, Suzuki, K, Hungria, V, Balari, AS, Clement-Filliatre, L, Hulin, C, Magen, H, Iida, S, Maisnar, V, Karlin, L, Pour, L, Touzeau, C, Yang, S, Kosh, M, Delioukina, M, Heuck, C, and Moreau, P

Published
2021

13. Melflufen Plus Dexamethasone in Patients with Relapsed/Refractory Multiple Myeloma (RRMM) Exposed or Refractory to Prior Alkylators: A Pooled Analysis of the O-12-M1 and HORIZON Studies

Author

Rodriguez-Otero, P, Mateos, MV, Oriol, A, Larocca, A, Blade, J, Cavo, M, Leleu, X, Nadeem, O, Hiemenz, JW, Hassoun, H, Touzeau, C, Alegre, A, Paner, A, Maisel, C, Mazumder, A, Raptis, A, Thuresson, M, Harmenberg, J, Harlin, O, and Richardson, PG

Subjects
multiple myeloma, peptide-drug conjugate, alkylator, MM, melphalan flufenamide, melflufen
Published
2021

16. Pembrolizumab plus pomalidomide and dexamethasone for patients with relapsed or refractory multiple myeloma (KEYNOTE-183): a randomised, open-label, phase 3 trial

Author

Mateos, Maria-Victoria, Blacklock, Hilary, Schjesvold, Fredrik, Oriol, Albert, Simpson, David, George, Anupkumar, Goldschmidt, Hartmut, Larocca, Alessandra, Chanan-Khan, Asher, Sherbenou, Daniel, Avivi, Irit, Benyamini, Noam, Iida, Shinsuke, Matsumoto, Morio, Suzuki, Kenshi, Ribrag, Vincent, Usmani, Saad Z, Jagannath, Sundar, Ocio, Enrique M, Rodriguez-Otero, Paula, San Miguel, Jesus, Kher, Uma, Farooqui, Mohammed, Liao, Jason, Marinello, Patricia, Lonial, Sagar, KEYNOTE-183 Investigators, Nicol A, Grigoriadis G, Catalano J, LeBlanc R, Elemary M, Bahlis N, Facon T, Karlin L, Ribrag V, Attal M, Goldschmidt H, Engelhardt M, Weisel K, Mackensen A, Nagler A, Ben Yehuda D, Avivi I, Benyamini N, Magen-Nativ H, Palumbo A, Cavo M, Tobinai K, Iida S, Chou T, Suzuki K, Kosugi H, Taniwaki M, Sunami K, Matsumoto M, Ando K, Ganly P, Blacklock H, Simpson D, George A, Schjesvold F, Gjertsen B, Lahuerta J, Blade J, Oriol Rocafiguera A, Mateos M, Rodriguez-Otero P, Larson S, Atanackovic D, Devarakonda S, Bitran J, Zonder J, Morganstein N, Hay M, Chanan-Khan A, Saylors G, Kio E, Oliff I, Kirkel D, Shtivelband M, Yuen C, Yee A, Shah J, Htut M, Raza S, Chhabra S, Stiff P, Hari P, Bank B, Malek E, Gasparetto C, Faroun Y, Sherbenou D, Kreisle W, Singhal S, Rosenblatt J, Usmani S, Lee W, Safah H, Lutzky J, Suh J, Pan D, Baron A, Manges R, Steis R, Oliveira M, Moreb J, Callander N, Anz B, Raptis A, Stampleman L, Melear J, Boyd T, Garbo L, Klein L, Shao S, Lyons R, McIntyre K, Tarantolo S, Yasenchak C, Yimer H., Mateos, Maria-Victoria, Blacklock, Hilary, Schjesvold, Fredrik, Oriol, Albert, Simpson, David, George, Anupkumar, Goldschmidt, Hartmut, Larocca, Alessandra, Chanan-Khan, Asher, Sherbenou, Daniel, Avivi, Irit, Benyamini, Noam, Iida, Shinsuke, Matsumoto, Morio, Suzuki, Kenshi, Ribrag, Vincent, Usmani, Saad Z, Jagannath, Sundar, Ocio, Enrique M, Rodriguez-Otero, Paula, San Miguel, Jesu, Kher, Uma, Farooqui, Mohammed, Liao, Jason, Marinello, Patricia, Lonial, Sagar, KEYNOTE-183 Investigator, and Nicol A, Grigoriadis G, Catalano J, LeBlanc R, Elemary M, Bahlis N, Facon T, Karlin L, Ribrag V, Attal M, Goldschmidt H, Engelhardt M, Weisel K, Mackensen A, Nagler A, Ben Yehuda D, Avivi I, Benyamini N, Magen-Nativ H, Palumbo A, Cavo M, Tobinai K, Iida S, Chou T, Suzuki K, Kosugi H, Taniwaki M, Sunami K, Matsumoto M, Ando K, Ganly P, Blacklock H, Simpson D, George A, Schjesvold F, Gjertsen B, Lahuerta J, Blade J, Oriol Rocafiguera A, Mateos M, Rodriguez-Otero P, Larson S, Atanackovic D, Devarakonda S, Bitran J, Zonder J, Morganstein N, Hay M, Chanan-Khan A, Saylors G, Kio E, Oliff I, Kirkel D, Shtivelband M, Yuen C, Yee A, Shah J, Htut M, Raza S, Chhabra S, Stiff P, Hari P, Bank B, Malek E, Gasparetto C, Faroun Y, Sherbenou D, Kreisle W, Singhal S, Rosenblatt J, Usmani S, Lee W, Safah H, Lutzky J, Suh J, Pan D, Baron A, Manges R, Steis R, Oliveira M, Moreb J, Callander N, Anz B, Raptis A, Stampleman L, Melear J, Boyd T, Garbo L, Klein L, Shao S, Lyons R, McIntyre K, Tarantolo S, Yasenchak C, Yimer H.

Subjects
Male, medicine.medical_specialty, Pembrolizumab, Antibodies, Monoclonal, Humanized, Dexamethasone, Drug Administration Schedule, 03 medical and health sciences, Pembrolizumab, pomalidomide, dexamethasone, KEYNOTE-183, 0302 clinical medicine, Recurrence, Internal medicine, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Progression-free survival, Survival rate, Multiple myeloma, Aged, Proportional Hazards Models, Lenalidomide, Aged, 80 and over, Performance status, business.industry, Hematology, medicine.disease, Pomalidomide, Interim analysis, Progression-Free Survival, Thalidomide, Survival Rate, Myocarditis, Editorial Commentary, Treatment Outcome, Stevens-Johnson Syndrome, 030220 oncology & carcinogenesis, Female, Multiple Myeloma, business, 030215 immunology, medicine.drug
Abstract

Summary Background Pomalidomide and dexamethasone is a standard of care for patients with multiple myeloma in whom bortezomib and lenalidomide treatment has failed. KEYNOTE-183 assessed efficacy and safety of pomalidomide and dexamethasone with or without pembrolizumab in patients with relapsed or refractory multiple myeloma. Here, we present the findings of an unplanned, ad-hoc interim analysis at the request of the US Food and Drug Administration (FDA). Methods KEYNOTE-183 was a randomised, open-label, phase 3 trial done at 97 medical centres across 11 countries (Australia, Canada, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Spain, and USA). Patients aged at least 18 years with multiple myeloma, an Eastern Cooperative Oncology Group (ECOG) performance status 0 or 1, previously treated with at least two lines of therapy (excluding pomalidomide) and refractory to the last line were randomly assigned 1:1 to the pembrolizumab plus pomalidomide and dexamethasone group or the pomalidomide and dexamethasone group via an interactive voice response or integrated web response system. Patients received oral pomalidomide 4 mg daily on days 1–21 and oral low-dose dexamethasone 40 mg on days 1, 8, 15, and 22 in 28-day cycles, with or without intravenous pembrolizumab 200 mg every 3 weeks. The dual primary endpoints were progression-free survival and overall survival. Efficacy was assessed in all randomly assigned patients and safety was assessed in patients who received at least one dose of study treatment. The trial is registered at ClinicalTrials.gov , number NCT02576977 , and it is closed for accrual. Findings Between Jan 18, 2016, and June 7, 2017, 249 patients were randomly assigned to either the pembrolizumab plus pomalidomide and dexamethasone group (n=125) or the pomalidomide and dexamethasone group (n=124). On July 3, 2017, the FDA established that risks associated with the triple combination outweighed benefits and halted the study. Median follow-up was 8·1 months (IQR 4·5–10·9). Median progression-free survival was 5·6 months (95% CI 3·7–7·5) in the pembrolizumab plus pomalidomide and dexamethasone group versus 8·4 months (5·9–not reached) in the pomalidomide and dexamethasone group; progression-free survival estimates at 6 months were 48% (95% CI 37–58) versus 60% (49–69) at 6 months (hazard ratio [HR] 1·53; 95% CI 1·05–2·22; p=0·98). Median overall survival was not reached (95% CI 12·9–not reached) versus 15·2 months (12·7–not reached; HR 1·61; 95% CI 0·91–2·85; p=0·95); overall survival estimates at 6 months were 82% (95% CI 74–88) versus 90% (82–95). Serious adverse events occurred in 75 (63%) of 120 patients in the pembrolizumab plus pomalidomide and dexamethasone group versus 56 (46%) of 121 patients in the pomalidomide and dexamethasone group. Four (3%) treatment-related deaths occurred in the pembrolizumab plus pomalidomide and dexamethasone group (one each of unknown cause, neutropenic sepsis, myocarditis, and Stevens–Johnson syndrome); myocarditis and Stevens-Johnson syndrome were considered related to pembrolizumab. No treatment-related deaths were reported in the pomalidomide and dexamethasone group. Interpretation The results from this unplanned, FDA-requested, interim analysis showed that the benefit–risk profile of pembrolizumab plus pomalidomide and dexamethasone is unfavourable for patients with relapsed or refractory multiple myeloma. Funding Merck Sharp & Dohme, a subsidiary of Merck & Co (Kenilworth, NJ, USA).

Published
2019

17. A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial

Author

Facon, T. Dimopoulos, M.A. Meuleman, N. Belch, A. Mohty, M. Chen, W.-M. Kim, K. Zamagni, E. Rodriguez-Otero, P. Renwick, W. Rose, C. Tempescul, A. Boyle, E. Manier, S. Attal, M. Moreau, P. Macro, M. Leleu, X. Lorraine Chretien, M. Ludwig, H. Guo, S. Sturniolo, M. Tinel, A. Silvia Monzini, M. Costa, B. Houck, V. Hulin, C. Yves Mary, J.

Abstract

Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores for age, Charlson Comorbidity Index (CCI), and Eastern Cooperative Oncology Group performance status (ECOG PS), instead of the EQ-5D quality-of-life questionnaire, as previously reported. ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%). Frail patients experienced worse progression-free and overall survival vs nonfrail patients. Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III). Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events. Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients. © 2019, The Author(s).

Published
2020

18. CAR T-Cells in Multiple Myeloma Are Ready for Prime Time

Author

Rodriguez-Otero, P. (Paula), Prosper, F. (Felipe), Alfonso-Piérola, A. (Ana), Paiva, B. (Bruno), and San-Miguel, J.F. (Jesús F.)

Subjects
B-cell maturation antigen, Chimeric antigen receptor T cell (CAR T-cell) therapy, Immunotherapy, Relapse and refractory multiple myeloma, Área de Medicina Clínica y Epidemiología
Abstract

The survival of patients with multiple myeloma (MM) has been dramatically improved in the last decade thanks to the incorporation of second-generation proteasome inhibitors (PI), immunomodulatory drugs (IMID), and, more recently, anti-CD38 monoclonal antibodies (MoAb). Nevertheless, still, a major proportion of MM patients will relapse, underscoring the need for new therapies in this disease. Moreover, survival in patients failing the current standard of care regimens (including PI, IMIDs, and anti-CD38 MoAb), which is now defined as triple-class refractory, remains dismal, and new drugs with different mechanism of action are needed. B-cell maturation antigen (BCMA)-targeted therapies and in particular chimeric antigen receptor T cell (CAR T-cell) treatment have emerged as promising platforms to overcome refractoriness to conventional drugs. In this manuscript, we review the current available data regarding CAR T-cell therapy for MM, with a special focus on target selection, clinical results, limitations, and future strategies.

Published
2020

19. 18F-FDG and 11C-Methionine PET/CT in Newly Diagnosed Multiple Myeloma Patients: Comparison of Volume-Based PET Biomarkers

Author

Morales-Lozano, M. I. (Mª Isabel), Viering, O. (Oliver), Samnick, S. (Samuel), Rodriguez-Otero, P. (Paula), Buck, A.K. (Andreas K.), Marcos-Jubilar, M. (María), Rasche, L. (Leo), Prieto, E. (Elena), Kortüm, K.M. (K. Martin), San-Miguel, J.F. (Jesús F.), Garcia-Velloso, M. J. (María José), and Lapa, C. (Constantin)

Subjects
Methionine, Multiple myeloma, Total lesion glycolysis (TLG), Metabolic tumor volume (MTV), Total lesion methionine uptake (TLMU)
Abstract

11C-methionine (11C-MET) is a new positron emission tomography (PET) tracer for the assessment of disease activity in multiple myeloma (MM) patients, with preliminary data suggesting higher sensitivity and specificity than 18F-fluorodeoxyglucose (18F-FDG). However, the value of tumor burden biomarkers has yet to be investigated. Our goals were to corroborate the superiority of 11C-MET for MM staging and to compare its suitability for the assessment of metabolic tumor burden biomarkers in comparison to 18F-FDG. Twenty-two patients with newly diagnosed, treatment-naïve symptomatic MM who had undergone 11C-MET and 18F-FDG PET/CT were evaluated. Standardized uptake values (SUV) were determined and compared with total metabolic tumor volume (TMTV) for both tracers: total lesion glycolysis (TLG) and total lesion 11C-MET uptake (TLMU). PET-derived values were compared to Revised International Staging System (R-ISS), cytogenetic, and serologic MM markers such as M component, beta 2 microglobulin (B2M), serum free light chains (FLC), albumin, and lactate dehydrogenase (LDH). In 11 patients (50%), 11C-MET detected more focal lesions (FL) than FDG (p < 0.01). SUVmax, SUVmean, SUVpeak, TMTV, and TLMU were also significantly higher in 11C-MET than in 18F-FDG (p < 0.05, respectively). 11C-MET PET biomarkers had a better correlation with tumor burden (bone marrow plasma cell infiltration, M component; p < 0.05 versus p = n.s. respectively). This pilot study suggests that 11C-MET PET/CT is a more sensitive marker for the assessment of myeloma tumor burden than 18F-FDG. Its implications for prognosis evaluation need further investigation.

Published
2020

20. Immunogenomic identification and characterization of granulocytic myeloid-derived suppressor cells in multiple myeloma

Author

Perez, C, Botta, C, Zabaleta, A, Puig, N, Cedena, MT, Goicoechea, I, Alameda, D, San Jose-Eneriz, E, Merino, J, Rodriguez-Otero, P, Maia, C, Alignani, D, Maiso, P, Manrique, I, Lara-Astiaso, D, Vilas-Zornoza, A, Sarvide, S, Riillo, C, Rossi, M, Rosinol, L, Oriol, A, Blanchard, MJ, Rios, R, Sureda, A, Martin, J, Martinez, R, Bargay, J, De la Rubia, J, Hernandez, MT, Martinez-Lopez, J, Orfao, A, Agirre, X, Prosper, F, Mateos, MV, Lahuerta, JJ, Blade, J, San-Miguel, JF, Paiva, B, Grp Espanol Mieloma, and Programa Estudio Terapeutica Hemop

Abstract

Granulocytic myeloid-derived suppressor cells (G-MDSCs) promote tumor growth and immunosuppression in multiple myeloma (MM). However, their phenotype is not well established for accurate monitoring or clinical translation. We aimed to provide the phenotypic profile of G-MDSCs based on their prognostic significance in MM, immunosuppressive potential, and molecular program. The preestablished phenotype of G-MDSCs was evaluated in bone marrow samples from controls and MM patients using multidimensional flow cytometry; surprisingly, we found that CD11b(+)CD14(-)CD15(+)CD33(+) HLADR(+) cells over-lapped with common eosinophils and neutrophils, which were not expanded in MM patients. Therefore, we relied on automated clustering to unbiasedly identify all granulocytic subsets in the tumor microenvironment: basophils, eosinophils, and immature, intermediate, and mature neutrophils. In a series of 267 newly diagnosed MM patients (GEM2012MENOS65 trial), only the frequency of mature neutrophils at diagnosis was significantly associated with patient outcome, and a high mature neutrophil/T-cell ratio resulted in inferior progression-free survival (P < .001). Upon fluorescence-activated cell sorting of each neutrophil subset, T-cell proliferation decreased in the presence of mature neutrophils (0.5-fold; P = .016), and the cytotoxic potential of T cells engaged by a BCMAxCD3-bispecific antibody increasednotably with the depletion of mature neutrophils (fourfold; P = .0007). Most interestingly, RNA sequencing of the 3 subsets revealed that G-MDSC-related genes were specifically upregulated in mature neutrophils from MM patients vs controls because of differential chromatin accessibility. Taken together, our results establish a correlation between the clinical significance, immunosuppressive potential, and transcriptional network of well-defined neutrophil subsets, providing for the first time a set of optimal markers (CD11b/CD13/CD16) for accurate monitoring of G-MDSCs in MM.

Published
2020

24. Early myeloma-related death in elderly patients: development of a clinical prognostic score and evaluation of response sustainability role (vol 32, pg 2427, 2018)

Author

Rodriguez-Otero P, Mateos M, Martinez-Lopez J, Martin-Calvo N, Hernandez M, Ocio E, Rosinol L, Martinez R, Teruel A, Gutierrez N, Bargay J, Bengoechea E, Gonzalez Y, de Oteyza J, Gironella M, Encinas C, Martin J, Cabrera C, Palomera L, de Arriba F, Cedena M, Paiva B, Puig N, Oriol A, Blade J, Lahuerta J, and San Miguel J

Published
2019

26. Epigenetic Silencing of the Tumor Suppressor MicroRNA Hsa-miR-124a Regulates CDK6 Expression and Confers a Poor Prognosis in Acute Lymphoblastic Leukemia

Author

Agirre-Ena, X. (Xabier), Vilas, A. (Amaia), Jimenez-Velasco, A. (A.), Martin-Subero, J.I. (Jose Ignacio), Cordeu, L. (Lucía), Garate, L. (Leire), San-Jose-Eneriz, E. (Edurne), Abizanda, G. (Gloria), Rodriguez-Otero, P. (Paula), Fortes, P. (Puri), Rifon, J. (Jose), Bandres, E. (Eva), Calasanz-Abinzano, M.J. (Maria Jose), Martin, V. (Vanesa), Heiniger, A. (A.), Torres, A. (Antonio), Siebert, R. (Reiner), Roman-Gomez, J. (José), and Prosper, F. (Felipe)

Subjects
Ciencias de la Salud::Oncología [Materias Investigacion]
Abstract

Whereas transcriptional silencing of genes due to epigenetic mechanisms is one of the most important alterations in acute lymphoblastic leukemia (ALL), some recent studies indicate that DNA methylation contributes to down-regulation of miRNAs during tumorigenesis.T o explore the epigenetic alterations of miRNAs in ALL, we analyzed the methylation and chromatin status of the miR-124a loci in ALL.E xpression of miR-124a was down-regulated in ALL by hypermethylation of the promoter and histone modifications including decreased levels of 3mk4H3 and AcH3 and increased levels of 2mK9H3, 3mK9H3, and 3mK27H3.Epigenetic down-regulation of miR-124a induced an up-regulation of its target, CDK6, and phosphorylation of retinoblastoma (Rb) and contributed to the abnormal proliferation of ALL cells both in vitro and in vivo.Cyc lin-dependent kinase 6 (CDK6) inhibition by sodium butyrate or PD-0332991 decreased ALL cell growth in vitro, whereas overexpression of pre-miR124a led to decreased tumorigenicity in a xenogeneic in vivo Rag2 / ;c / mouse model.The clinical implications of these findings were analyzed in a group of 353 patients diagnosed with ALL.M ethylation of hsa-miR-124a was observed in 59% of the patients, which correlated with down-regulation of miR-124a (P < 0.001). Furthermore, hypermethylation of hsa-miR-124a was associated with higher relapse rate (P = 0.001) and mortality rate (P < 0.001), being an independent prognostic factor for disease-free survival (P < 0.001) and overall survival (P = 0.005) in the multivariate analysis.These results provide the grounds for new therapeutic strategies in ALL either targeting the epigenetic regulation of microRNAs and/or directly targeting the CDK6-Rb pathway.

Published
2009

29. PREDICTORS OF EARLY DEATH RELATED TO ACTIVE MULTIPLE MYELOMA IN ELDERLY PATIENTS RECEIVING OPTIMIZED FRONTLINE TREATMENT COMBINATIONS

Author

Rodriguez Otero, P., Mateos, M. V., Joaquin, M. -L, Miguel Teodoro, H., Enrique M, O., Rosinol, L., Martinez, R., Teruel, A. -I, Gutierrez, N. C., Oriol, A., Martin-Calvo, N., Paiva, B., Bargay, J., Bengoechea, E., Gonzalez, Y., Perez Oteyza, J., Gironella, M., Encinas, C., Martin, J., Cabrera, C., Palomera, L., Arriba, F., Cedena, M. T., Puig, N., Blade, J., Juan José Lahuerta, and San Miguel, J. F.

31. Melflufen and Dexamethasone in Heavily Pretreated Relapsed and Refractory Multiple Myeloma

Author

Hani Hassoun, Jacob P. Laubach, Jan S. Moreb, Sara Thuresson, Paula Rodriguez-Otero, Marcus Thuresson, Michele Cavo, Albert Oriol, Maria-Victoria Mateos, Joan Bladé, John W. Hiemenz, Adrian Alegre, Amitabha Mazumder, Horizon (Op ) Investigators, Kenneth C. Anderson, Omar Nadeem, Johan Harmenberg, Nicolaas A Bakker, Xavier Leleu, Alessandra Larocca, Christopher Maisel, Paul G. Richardson, Agne Paner, Anastasios Raptis, Cyrille Touzeau, Catriona Byrne, Harvard Medical School [Boston] (HMS), Hospital Universitari Germans Trias I Pujol [Badalona], Università degli studi di Torino = University of Turin (UNITO), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona (UB), University of Bologna/Università di Bologna, Clínica Universidad de Navarra [Pamplona], Centre hospitalier universitaire de Poitiers (CHU Poitiers), University of Florida [Gainesville] (UF), Memorial Sloane Kettering Cancer Center [New York], Regulation of Bcl2 and p53 Networks in Multiple Myeloma and Mantle Cell Lymphoma (CRCINA-ÉQUIPE 10), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), Université d'Angers (UA), Université de Nantes (UN), Site de Recherche Intégrée sur le Cancer [Nantes] (SIRIC), Centre hospitalier universitaire de Nantes (CHU Nantes), SIRIC ILIAD [Angers, Nantes], Hospital Universitario Quironsalud, Rush University Medical Center [Chicago], Baylor Scott & White Charles A. Sammons Cancer Center [Dallas, TX, USA], Oncology Institute of Hope and Innovation [Glendale, CA, USA] (OIHI), University of Pittsburgh School of Medicine, Pennsylvania Commonwealth System of Higher Education (PCSHE), Novant Health Forsyth Medical Center [Winston-Salem, NC, USA] (NHFMC), Oncopeptides AB [Stockholm, Sweden], Instituto de Investigación Biomédica de Salamanca [Salamanca, Spain] (IBSAL/CIC), HORIZON (OP-106) Investigators, Bernardo, Elizabeth, Università degli studi di Torino (UNITO), University of Bologna, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), Richardson P.G., Oriol A., Larocca A., Blade J., Cavo M., Rodriguez-Otero P., Leleu X., Nadeem O., Hiemenz J.W., Hassoun H., Touzeau C., Alegre A., Paner A., Maisel C., Mazumder A., Raptis A., Moreb J.S., Anderson K.C., Laubach J.P., Thuresson S., Thuresson M., Byrne C., Harmenberg J., Bakker N.A., and Mateos M.-V.

Subjects
Adult, Male, Cancer Research, Time Factors, Time Factor, Phenylalanine, [SDV.CAN]Life Sciences [q-bio]/Cancer, Tumor cells, Drug resistance, Dexamethasone, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Recurrence, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Neoplasm, Progression-free survival, Melphalan, Aged, 030304 developmental biology, Aged, 80 and over, 0303 health sciences, Antineoplastic Combined Chemotherapy Protocol, business.industry, Refractory Multiple Myeloma, Middle Aged, medicine.disease, Progression-Free Survival, United States, 3. Good health, Europe, Clinical trial, Oncology, Drug Resistance, Neoplasm, 030220 oncology & carcinogenesis, Disease Progression, Cancer research, Female, Multiple Myeloma, business, Human, Conjugate, medicine.drug
Abstract

PURPOSE Melphalan flufenamide (melflufen) is a first-in-class peptide-drug conjugate that targets aminopeptidases and rapidly and selectively releases alkylating agents into tumor cells. The phase II HORIZON trial evaluated the efficacy of melflufen plus dexamethasone in relapsed and refractory multiple myeloma (RRMM), a population with an important unmet medical need. PATIENTS AND METHODS Patients with RRMM refractory to pomalidomide and/or an anti-CD38 monoclonal antibody received melflufen 40 mg intravenously on day 1 of each 28-day cycle plus once weekly oral dexamethasone at a dose of 40 mg (20 mg in patients older than 75 years). The primary end point was overall response rate (partial response or better) assessed by the investigator and confirmed by independent review. Secondary end points included duration of response, progression-free survival, overall survival, and safety. The primary analysis is complete with long-term follow-up ongoing. RESULTS Of 157 patients (median age 65 years; median five prior lines of therapy) enrolled and treated, 119 patients (76%) had triple-class–refractory disease, 55 (35%) had extramedullary disease, and 92 (59%) were refractory to previous alkylator therapy. The overall response rate was 29% in the all-treated population, with 26% in the triple-class–refractory population. In the all-treated population, median duration of response was 5.5 months, median progression-free survival was 4.2 months, and median overall survival was 11.6 months at a median follow-up of 14 months. Grade ≥ 3 treatment-emergent adverse events occurred in 96% of patients, most commonly neutropenia (79%), thrombocytopenia (76%), and anemia (43%). Pneumonia (10%) was the most common grade 3/4 nonhematologic event. Thrombocytopenia and bleeding (both grade 3/4 but fully reversible) occurred concomitantly in four patients. GI events, reported in 97 patients (62%), were predominantly grade 1/2 (93%); none were grade 4. CONCLUSION Melflufen plus dexamethasone showed clinically meaningful efficacy and a manageable safety profile in patients with heavily pretreated RRMM, including those with triple-class–refractory and extramedullary disease.

Published
2021

32. A simplified frailty scale predicts outcomes in transplant-ineligible patients with newly diagnosed multiple myeloma treated in the FIRST (MM-020) trial

Author

Margaret Macro, Andrew Ar Belch, Antoine Tinel, Nathalie Meuleman, Jean Yves Mary, Christian Rose, Paula Rodriguez-Otero, Philippe Moreau, Wenming Chen, Michel Attal, Marie Lorraine Chretien, William Renwick, Kihyun Kim, Meletios A. Dimopoulos, Eileen M Boyle, Xavier Leleu, Michael Sturniolo, Thierry Facon, Heinz Ludwig, Mara Silvia Monzini, Vanessa Houck, Elena Zamagni, Adrian Tempescul, Salomon Manier, Cyrille Hulin, Shien Guo, Mohamad Mohty, Bruno M. Costa, Facon T., Dimopoulos M.A., Meuleman N., Belch A., Mohty M., Chen W.-M., Kim K., Zamagni E., Rodriguez-Otero P., Renwick W., Rose C., Tempescul A., Boyle E., Manier S., Attal M., Moreau P., Macro M., Leleu X., Lorraine Chretien M., Ludwig H., Guo S., Sturniolo M., Tinel A., Silvia Monzini M., Costa B., Houck V., Hulin C., Yves Mary J., CIC CHU ( Lille)/inserm, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille, Droit et Santé, National and Kapodistrian University of Athens (NKUA), Institut Jules Bordet [Bruxelles], Faculté de Médecine [Bruxelles] (ULB), Université libre de Bruxelles (ULB)-Université libre de Bruxelles (ULB), Cross Cancer Institute [Edmonton, AB, Canada], Service d'immunologie et hématologies biologiques [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Capital Medical University, Beijing, Samsung Medical Center Sungkyunkwan University School of Medicine, Institute Division of Hematology/Oncology, Azienda Ospedaliero-Universitaria, Universidad de Navarra [Pamplona] (UNAV), Western Health The University of Melbourne, Université catholique de Lille (UCL), CHRU Brest - Service d'Hématologie (CHU-Brest-Hemato), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Institut Universitaire du Cancer de Toulouse - Oncopole (IUCT Oncopole - UMR 1037), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Hôtel-Dieu de Nantes - Centre Hospitalier Universitaire de Nantes (Hôpital Hôtel-Dieu de Nantes - CHU de Nantes), Hôpital Universitaire de Caen, Hôpital de la Milétrie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Wilhelminenspital Vienna, Evidera, Celgene Corporation, Celgene International, Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Michel, Geneviève, Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Wilhelminenspital Vienna = Wilhelminen Hospital

Subjects
0301 basic medicine, Male, Cancer Research, [SDV]Life Sciences [q-bio], Dexamethasone, 0302 clinical medicine, Clinical trials, Multiple myeloma, Antineoplastic Combined Chemotherapy Protocols, Stage (cooking), Lenalidomide, Melphalan, Aged, 80 and over, Frailty, Hematology, Middle Aged, 3. Good health, Thalidomide, [SDV] Life Sciences [q-bio], Treatment Outcome, Oncology, 030220 oncology & carcinogenesis, Female, Multiple Myeloma, Haematological diseases, Human, Adult, medicine.medical_specialty, FIRST (MM-020) trial, Frail Elderly, Newly diagnosed, Transplant ineligible, Anesthésiologie, Article, 03 medical and health sciences, Internal medicine, medicine, Humans, In patient, Adverse effect, Aged, Antineoplastic Combined Chemotherapy Protocol, business.industry, medicine.disease, Clinical trial, Cancérologie, 030104 developmental biology, Charlson comorbidity index, Prednisone, business, Hématologie
Abstract

Patients with multiple myeloma are generally older and vary in fitness levels, which may influence the clinical benefit of treatment. Patients from the large, phase 3 FIRST trial in newly diagnosed multiple myeloma (NDMM) were retrospectively investigated to determine outcomes based on frailty using scores for age, Charlson Comorbidity Index (CCI), and Eastern Cooperative Oncology Group performance status (ECOG PS), instead of the EQ-5D quality-of-life questionnaire, as previously reported. ECOG PS (n = 1618) was investigated in frailty groups: frail (49%) and nonfrail (51%). Frail patients experienced worse progression-free and overall survival vs nonfrail patients. Prognostic assessment was improved when combining frailty and International Staging System stage (I/II vs III). Frail patients had a higher risk of developing grade 3/4 treatment-emergent adverse events. Treatment effects observed in the FIRST trial were confirmed per frailty group and per frailty and ISS group. The use of this ECOG PS–containing frailty scale as a predictive measure of clinical outcomes in patients with transplant-ineligible NDMM is supported by data from the FIRST trial. This score, based on age, CCI, and ECOG PS, can be easily replicated and may help design future myeloma studies in frail or nonfrail elderly patients., SCOPUS: ar.j, info:eu-repo/semantics/published

Published
2019

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