Abstract：
BACKGROUND: Lenalidomide (R), bortezomib (V), and dexamethasone (d) is a standard-of-care regimen in newly diagnosed multiple myeloma (NDMM); however, characteristics and outcomes for nontransplanted patients receiving frontline RVd are not well understood.
METHODS: The ConnectⓇ MM Registry is a large, US, multicenter, prospective observational cohort study of NDMM patients.
METHODS: This analysis investigated characteristics and outcomes of patients who received RVd alone or followed by Rd or R (RVd ± Rd/R) who did not undergo frontline autologous stem cell transplantation.
RESULTS: As of August 2021, 314 of 1979 nontransplanted patients received RVd ± Rd/R as initial therapy. Of these, 135 were aged ≤ 65 years and 179 were > 65 years. 108 patients had time to relapse (TTR) of ≤ 12 months and 182 had TTR > 12 months. Baseline characteristics were comparable regardless of TTR and age group except renal function, which was more commonly impaired in older patients. Among patients aged ≤ 65 and > 65 years, median duration of first-line treatment was 6.3 and 9.0 months, median time to next line for those who received second-line therapy was 15.5 and 15.2 months, median progression-free survival (PFS) was 19.3 and 23.0 months, and median overall survival was 60.0 and 59.1 months, respectively. High-risk disease (per IMWG criteria) and high serum calcium were associated with higher hazard of progression or death; the adjusted PFS hazard ratio with respect to age (≤ 65 vs. > 65 years) based on multivariable analysis was 1.18 (0.89-1.57; P = .25).
CONCLUSIONS: These results indicate RVd is active across age groups and provide a better understanding of outcomes with RVd in NDMM.
METHODS: The ConnectⓇ MM Registry is a large, US, multicenter, prospective observational cohort study of NDMM patients.
METHODS: This analysis investigated characteristics and outcomes of patients who received RVd alone or followed by Rd or R (RVd ± Rd/R) who did not undergo frontline autologous stem cell transplantation.
RESULTS: As of August 2021, 314 of 1979 nontransplanted patients received RVd ± Rd/R as initial therapy. Of these, 135 were aged ≤ 65 years and 179 were > 65 years. 108 patients had time to relapse (TTR) of ≤ 12 months and 182 had TTR > 12 months. Baseline characteristics were comparable regardless of TTR and age group except renal function, which was more commonly impaired in older patients. Among patients aged ≤ 65 and > 65 years, median duration of first-line treatment was 6.3 and 9.0 months, median time to next line for those who received second-line therapy was 15.5 and 15.2 months, median progression-free survival (PFS) was 19.3 and 23.0 months, and median overall survival was 60.0 and 59.1 months, respectively. High-risk disease (per IMWG criteria) and high serum calcium were associated with higher hazard of progression or death; the adjusted PFS hazard ratio with respect to age (≤ 65 vs. > 65 years) based on multivariable analysis was 1.18 (0.89-1.57; P = .25).
CONCLUSIONS: These results indicate RVd is active across age groups and provide a better understanding of outcomes with RVd in NDMM.
摘要：
背景：来那度胺（R），硼替佐米（V），地塞米松（d）是新诊断的多发性骨髓瘤（NDMM）的标准治疗方案；然而，接受一线RVd的非移植患者的特征和结局尚不清楚.
方法：连接的MM注册表是一个很大的，US,多中心，NDMM患者的前瞻性观察性队列研究。
方法：该分析调查了单独接受RVd或随后接受Rd或R（RVd±Rd/R）但未接受一线自体干细胞移植的患者的特征和结局。
结果：截至2021年8月，1979年未移植的患者中有314例接受了RVd±Rd/R作为初始治疗。其中,135例年龄≤65岁，179例年龄>65岁。108例患者的复发时间（TTR）≤12个月，182例患者的TTR>12个月。无论TTR和年龄组，基线特征均具有可比性，除了肾功能，这在老年患者中更常见。在≤65岁和>65岁的患者中，一线治疗的中位持续时间为6.3和9.0个月,接受二线治疗的患者的下一线中位时间为15.5和15.2个月，中位无进展生存期（PFS）分别为19.3个月和23.0个月，中位总生存期为60.0和59.1个月，分别。高风险疾病（根据IMWG标准）和高血清钙与更高的进展或死亡风险相关；调整后的PFS风险比与年龄（≤65vs.>65岁）基于多变量分析为1.18（0.89-1.57；P=.25）。
结论：这些结果表明RVd在各年龄组中都是活跃的，并且可以更好地理解RVd在NDMM中的结果。
方法：连接的MM注册表是一个很大的，US,多中心，NDMM患者的前瞻性观察性队列研究。
方法：该分析调查了单独接受RVd或随后接受Rd或R（RVd±Rd/R）但未接受一线自体干细胞移植的患者的特征和结局。
结果：截至2021年8月，1979年未移植的患者中有314例接受了RVd±Rd/R作为初始治疗。其中,135例年龄≤65岁，179例年龄>65岁。108例患者的复发时间（TTR）≤12个月，182例患者的TTR>12个月。无论TTR和年龄组，基线特征均具有可比性，除了肾功能，这在老年患者中更常见。在≤65岁和>65岁的患者中，一线治疗的中位持续时间为6.3和9.0个月,接受二线治疗的患者的下一线中位时间为15.5和15.2个月，中位无进展生存期（PFS）分别为19.3个月和23.0个月，中位总生存期为60.0和59.1个月，分别。高风险疾病（根据IMWG标准）和高血清钙与更高的进展或死亡风险相关；调整后的PFS风险比与年龄（≤65vs.>65岁）基于多变量分析为1.18（0.89-1.57；P=.25）。
结论：这些结果表明RVd在各年龄组中都是活跃的，并且可以更好地理解RVd在NDMM中的结果。
