Multiple Myeloma Coverage from Every Angle

First-Line Treatment of Myeloma: Factors With Prognostic Value of Success

By: Celeste L. Dixon
Posted: Monday, January 28, 2019

Pretreatment plasma levels of four major cytokines and angiogenic factors have predictive significance for response to initial treatment for patients with multiple myeloma, according to research published in the Journal of Hematology & Oncology by Roberto Ria, MD, of the University of Bari “Aldo Moro” Medical School, Italy, and colleagues. Previously, no validated biomarkers had been available to help predict clinical outcomes of multiple myeloma treatments.

Results drawn from the GIMEMA MM0305 randomized controlled trial ( identifier NCT01063179) showed that the predictive cytokines and angiogenic factors are FGF-2, HGF, VEGF, and PDGF-β. This analysis utilized bone marrow and plasma levels of these four cytokines and angiogenic factors—along with those of ANG-2, IL-8, TNF-α, TIMP-1, and TIMP-2—that had been determined for this trial at diagnosis with an enzyme-linked immunosorbent assay. None of these levels differed significantly between the blood and bone marrow.

“A cutoff for each [cytokine and angiogenic factor] was established,” noted the team. As it turned out, “the therapeutic response of patients with blood plasma levels of cytokines and angiogenic factors lower than the cutoff was better than the response of those with higher levels in terms of [the] percentage of responding patients and quality of response.” In terms of utility, “circulating [cytokine and angiogenic factor] profiling might be particularly well suited for angiogenesis inhibitors and other drugs targeting the tumor microenvironment,” Dr. Ria and his co-investigators concluded.

The original GIMEMA MM0305 trial, which included patients from 61 Italian centers, attempted to establish bortezomib/melphalan/prednisone/thalidomide followed by maintenance with bortezomib/thalidomide was superior to bortezomib/melphalan/prednisone administered without maintenance in patients with multiple myeloma who were ineligible for autologous stem cell transplantation.

Disclosure: The study authors’ disclosures may be found at

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