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dc.contributor.authorJackson, GH
dc.contributor.authorPawlyn, C
dc.contributor.authorCairns, DA
dc.contributor.authorStriha, A
dc.contributor.authorCollett, C
dc.contributor.authorWaterhouse, A
dc.contributor.authorJones, JR
dc.contributor.authorWilson, J
dc.contributor.authorTaylor, C
dc.contributor.authorKishore, B
dc.contributor.authorGarg, M
dc.contributor.authorWilliams, CD
dc.contributor.authorKarunanithi, K
dc.contributor.authorLindsay, J
dc.contributor.authorJenner, MW
dc.contributor.authorCook, G
dc.contributor.authorRussell, NH
dc.contributor.authorDrayson, MT
dc.contributor.authorKaiser, MF
dc.contributor.authorOwen, RG
dc.contributor.authorGregory, WM
dc.contributor.authorDavies, FE
dc.contributor.authorMorgan, GJ
dc.contributor.authorUK NCRI Haemato-oncology Clinical Studies Group
dc.date.accessioned2020-08-27T08:54:33Z
dc.date.issued2020-07-12
dc.identifier.citationBritish journal of haematology, 2020
dc.identifier.issn0007-1048
dc.identifier.urihttps://repository.icr.ac.uk/handle/internal/4029
dc.identifier.eissn1365-2141
dc.identifier.doi10.1111/bjh.16945
dc.description.abstractSecond-generation immunomodulatory agents, such as lenalidomide, have a more favourable side-effect profile than the first-generation thalidomide, but their optimum combination and duration for patients with newly diagnosed transplant-ineligible myeloma (ND-TNE-MM) has not been defined. The most appropriate delivery and dosing regimens of these therapies for patients at advanced age and frailty status is also unclear. The Myeloma XI study compared cyclophosphamide, thalidomide and dexamethasone (CTDa) to cyclophosphamide, lenalidomide and dexamethasone (CRDa) as induction therapy, followed by a maintenance randomisation between ongoing therapy with lenalidomide or observation for patients with ND-TNE-MM. CRDa deepened response but did not improve progression-free (PFS) or overall survival (OS) compared to CTDa. However, analysis by age group highlighted significant differences in tolerability in older, frailer patients that may have limited treatment delivery and impacted outcome. Deeper responses and PFS and OS benefits with CRDa over CTDs were seen in patients aged ≤70 years, with an increase in toxicity and discontinuation observed in older patients. Our results highlight the importance of considering age and frailty in the approach to therapy for patients with ND-TNE-MM, highlighting the need for prospective validation of frailty adapted therapy approaches, which may improve outcomes by tailoring treatment to the individual.
dc.formatPrint-Electronic
dc.languageeng
dc.language.isoeng
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subjectUK NCRI Haemato-oncology Clinical Studies Group
dc.titleOptimising the value of immunomodulatory drugs during induction and maintenance in transplant ineligible patients with newly diagnosed multiple myeloma: results from Myeloma XI, a multicentre, open-label, randomised, Phase III trial.
dc.typeJournal Article
dcterms.dateAccepted2020-06-13
rioxxterms.versionofrecord10.1111/bjh.16945
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by/4.0
rioxxterms.licenseref.startdate2020-07-12
rioxxterms.typeJournal Article/Review
dc.relation.isPartOfBritish journal of haematology
pubs.notesNot known
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Myeloma Biology and Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Myeloma Group
pubs.organisational-group/ICR
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Cancer Therapeutics/Myeloma Biology and Therapeutics
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Molecular Pathology/Myeloma Group
pubs.publication-statusPublished
pubs.embargo.termsNot known
icr.researchteamMyeloma Biology and Therapeuticsen_US
icr.researchteamMyeloma Groupen_US
dc.contributor.icrauthorPawlyn, Charlotteen
dc.contributor.icrauthorKaiser, Martinen


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