Posted: Friday, May 19, 2023
Identifying patients likely to obtain a benefit from treatment with elotuzumab may be possible with a new scoring system using lymphocyte counts and beta-2 microglobulin (B2M), according to an article published in Scientific Reports. “The introduction of new drugs, particularly the monoclonal antibodies, elotuzumab, daratumumab, and isatuximab, has dramatically improved the prognosis of patients with multiple myeloma,” said Yutaka Shimazu, MD, of Kyoto University, Japan, and colleagues. “Because nonresponders might benefit from alternative treatments, it is important to select suitable patients for elotuzumab treatment beforehand.”
The authors analyzed data from 179 patients who underwent treatment for multiple myeloma with elotuzumab. Patients demonstrated a median time to next treatment of 6.3 months. Using univariate analysis, the researchers identified that patients with the longest time to next treatment had no cytogenetic abnormalities, more white blood cells, more lymphocytes, a nondeviated κ/λ ratio, lower B2M levels, fewer prior drug regimens, and no treatment with daratumumab. Multivariate analysis revealed that patients with longer times to next treatment had lymphocyte counts of 1,400/mL, a nondeviated κ/λ ratio between 0.1 and 10, and B2M levels less than 5.5 mg/L.
Results from a multivariate analysis led the group to use lymphocyte count, κ/λ ratio, and B2M levels to calculate a score for each patient. The score gives individuals 1 point if they have a lymphocyte count higher than 1,400/mL , a κ/λ ratio greater than 10, and B2M levels above 5.5 mg/L. Using this scoring model, the authors demonstrated that patients with a score of 0 had significantly longer times to next treatment and better survival than patients who scored 1 or higher. The authors noted that a cohort of studies should be conducted to validate the scoring system.
Disclosure: For full disclosures of the study authors, visit www.nature.com.