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ASTRO 2023: Impact of Radiation Therapy in a New Era of Myeloma Management

By: Julia Fiederlein Cipriano, MS
Posted: Monday, October 16, 2023

Alexandra Dreyfuss, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues conducted a pilot analysis of radiation therapy use and outcomes, as well as its impact on radiographic and biochemical markers, in this “new era” of multiple myeloma management. Their findings from a sampling cohort, which were presented during the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract 315), may guide the design of future prospective trials and inform novel approaches for incorporating radiation therapy into the systemic treatment paradigm.

The study enrolled 506 patients who received radiation therapy to 1,190 sites between January 2000 and June 2022. In this analysis, the investigators focused on those treated in 2019 (n = 50; treated lesions: n = 90). An additional cohort of 62 patients who underwent radiation therapy between 2016 and 2022 had available genomic data.

A total of 5% and 89% of treated sites had local and distant failures, respectively, at a median follow-up of 12.4 months; such remote recurrences were most commonly observed in both medullary and extramedullary sites (51%). Between 1 week and 1 month after radiation therapy, absolute decreases were seen in the marrow plasma cell percentage, M-spike, total protein, kappa/lambda light chain ratio, lesion size, and lesion standardized uptake value; however, in this limited sample, none were found to be significantly associated with disease control. Among the patients with available genomic data, TP53 (35%), HIST1 (34%), NRAS (34%), and KRAS (23%) were among the most frequently reported tumor mutations.

Disclosure: Dr. Dreyfuss reported no conflicts of interest.

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