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Shimazu, Yutaka; Kanda, Junya; Kosugi, Satoru; Ito, Tomoki; Kaneko, Hitomi; Imada, Kazunori; Shimura, Yuji; Fuchida, Shin-Ichi; Fukushima, Kentaro; Tanaka, Hirokazu; Yoshihara, Satoshi; Ohta, Kensuke; Uoshima, Nobuhiko; Yagi, Hideo; Shibayama, Hirohiko; Yamamura, Ryosuke; Tanaka, Yasuhiro; Uchiyama, Hitoji; Onda, Yoshiyuki; Adachi, Yoko; Hanamoto, Hitoshi; Takahashi, Ryoichi; Matsuda, Mitsuhiro; Miyoshi, Takashi; Takakuwa, Teruhito; Hino, Masayuki; Hosen, Naoki; Nomura, Shosaku; Shimazaki, Chihiro; Matsumura, Itaru; Takaori-Kondo, Akifumi; Kuroda, Junya
Scientific reports, 03/2023, Volume: 13, Issue: 1Journal Article
Novel therapeutic drugs have dramatically improved the overall survival of patients with multiple myeloma. We sought to identify the characteristics of patients likely to exhibit a durable response to one such drug, elotuzumab, by analyzing a real-world database in Japan. We analyzed 179 patients who underwent 201 elotuzumab treatments. The median time to next treatment (TTNT) with the 95% confidence interval was 6.29 months (5.18-9.20) in this cohort. Univariate analysis showed that patients with any of the following had longer TTNT: no high risk cytogenic abnormalities, more white blood cells, more lymphocytes, non-deviated κ/λ ratio, lower β microglobulin levels (B2MG), fewer prior drug regimens, no prior daratumumab use and better response after elotuzumab treatment. A multivariate analysis showed that TTNT was longer in patients with more lymphocytes (≥ 1400/μL), non-deviated κ/λ ratio (0.1-10), lower B2MG (< 5.5 mg/L) and no prior daratumumab use. We proposed a simple scoring system to predict the durability of the elotuzumab treatment effect by classifying the patients into three categories based on their lymphocyte counts (0 points for ≥ 1400/μL and 1 point for < 1400/μL) and κ/λ ratio (0 points for 0.1-10 and 1 point for < 0.1 or ≥ 10) or B2MG (0 points for < 5.5 mg/L and 1 point for ≥ 5.5 mg/L). The patients with a score of 0 showed significantly longer TTNT (p < 0.001) and better survival (p < 0.001) compared to those with a score of 1 or 2. Prospective cohort studies of elotuzumab treatment may be needed to validate the usefulness of our new scoring system.
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