There has been a great deal of debate over the past five years whether there is any advantage to achieving complete response (CR) during treatment for multiple myeloma. Here is the first definitive study I have seen that proves this to be the case. It doesn’t just show a small, measurable advantage for patients in CR vs patients with a very good response. This study shows median survival time as MORE THAN DOUBLE for patients in CR that undergo a transplant vs patients with some cancer or M-spike (Very Good or Very Good Partial Response)undergoing the same treatment. Here is a copy of the journal article:
CR represents an early index of potential long survival in multiple myeloma.
Wang M, Delasalle K, Feng L, Thomas S, Giralt S, Qazilbash M, Handy B, Lee JJ, Alexanian R.
University of Texas, M.D. Anderson Cancer Center, Houston, TX, USA.
To assess the impact of CR on survival in multiple myeloma. Retrospective evaluation of response and survival among 758 consecutive patients with multiple myeloma treated at a single center, of whom 395 patients received intensive therapy supported by autologous stem cells within the first year. Survival times were calculated after 1 and 2 years from the start of chemotherapy. On the basis of the response status after a 2-year landmark, the subsequent median survival was 9.7 years for patients with CR, 4.4 years for those with PR and 2.7 years for patients with NR (P<0.001). Longer survival was attributed in part to intensive therapy that converted the myeloma of 67% of patients with NR to PR or CR, and induced CR in 26% of patients with PR. Intensive therapy did not prolong survival for patients with CR after primary therapy. For patients with multiple myeloma, Cox regression analyses showed that CR was the dominant prognostic factor for long survival, followed by stage I disease, PR and intensive treatment as independent factors. A cure fraction of 2% was identified for nine patients who have remained in CR >10 years.Bone Marrow Transplantation advance online publication, 27 July 2009; doi:10.1038/bmt.2009.176.
This type of data personally effects me and my decision making. I will write about that tomorrow. Feel good, keep smiling and stay hopeful! Who know how long median survival rate will rise once new drugs and combination therapies are part of the mix! Pat