• Irena Ćojbašić, Miodrag Vučić, Ivan Tijanić, and Žarko Ćojbašić.
• MD, PhD. Assistant Professor, Department of Internal Medicine, Faculty of Medicine, University of Niš, Niš, Serbia; and Hematologist, Clinic of Hematology and Clinical Immunology, University Clinical Centre Niš, Niš, Serbia.
• Sao Paulo Med J. 2022 Mar 1; 140 (2): 222-228.

BackgroundIn this era of target therapies, novel data on the correlation between response endpoints and survival outcomes in multiple myeloma have arisen.ObjectiveTo determine the impact of quality of response on clinical outcomes, using first-line treatment, and identify risk factors influencing progression-free survival (PFS) and overall survival (OS) among myeloma patients.Design And SettingRetrospective analysis on myeloma patients who were treated at the Clinic of Hematology and Clinical Immunology, University Clinical Centre, Niš, Serbia, over a four-year period.MethodsA total of 108 newly diagnosed patients who received first-line therapy consisting of conventional chemotherapy or novel agent-based regimens were included in this analysis.ResultsThe quality of response to first-line therapy for the whole cohort was classified as follows: complete response (CR) in 19%; very good partial response (VGPR) in 23%; partial response (PR) in 38%; and less than PR for the remaining patients. After a median follow-up of 25.4 months, the three-year PFS and OS for the entire study population were 47% and 70%, respectively. Achievement of CR was the main factor associated with significantly prolonged PFS and OS, in comparison with patients who reached VGPR and PR. Likewise, addition of the new drugs bortezomib and thalidomide to standard chemotherapy led to considerably extended PFS and OS, compared with conventional therapy alone.ConclusionsThis analysis demonstrated that the quality of response after application of first-line treatment using novel agent-based regimens among multiple myeloma patients was a prognostic factor for PFS and OS, which are the most clinically relevant outcomes.

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