Impact of prolongation of overall treatment time and timing of brachytherapy on outcome of radiation therapy in carcinoma of uterine cervix

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15032-15032
Author(s):  
V. Goel ◽  
J. K. Singh. ◽  
M. K. Pandey
Keyword(s):  
Completion Time ◽  
Treatment Time ◽  
Residual Disease ◽  
Survival Rates ◽  
Carcinoma Cervix ◽  
Overall Treatment Time ◽  
Regional Control ◽  
Distant Failure ◽  
Bulky Tumor

15032 Background: Studies have described decreased pelvic control & survival rates in invasive ca cervix when overall time in definitive RT is prolonged. We evaluated impact of timing of brachytherapy on outcome. Methods: Retrospective analysis of 338 patients of ca cervix treated with radical RT from Jan 2002 to Dec 2002 at Mahavir Cancer Sansthan Patna. The median age was 50 yrs (23–80 yrs). 73% patients were postmenopausal. Histopathology was Squamous Cell in 97% patients. Most common presenting complaints were bleeding P/V (92%) & discharge P/V (82%); with stage I (3%), II (35%), III (43%), IV (5%), unknown stage in 14% cases. Results: Records of 338 patients (Stage IB to III) treated with definitive irradiation (combination of EBRT & ICRT) were reviewed with reference to loco regional control, distant failure and its correlation with patient and tumor variables including OTT. Out of 302 patients who received complete RT, 24 received 60 Gy in 30 fractions as they were found to be unsuitable or were unwilling for ICRT. The rest received a dose of 50 Gy/25 Fr to 50.4 Gy/28 Fr over a median duration of 37 days. 30 patients received concomitant chemo radiation (cisplatin 40 mg/m2/4 cycles). 276 patients received ICRT (dose 21 Gy in 3 Fractions with a median gap of 43 days (range 5–111) after completion of ERT. The median OTT for completion of ERT & ICRT was 75 days (range 54–177). At an average follow up of 18- 24 months residual disease was seen in 2 cases (0.6%), local recurrence in 14 cases (4%) & distant failure in 14 cases (4%). Post RT complications were seen in 4.7% cases and included small bowel obstruction in 6 cases, VVF in 4 & RVF in 6 cases. Significant correlation was seen between OTT and rate of loco regional recurrences. All local recurrences were seen when OTT was more than 75 days. No significant correlation could be drawn between age, Hemoglobin, tumor histology, & bulky vs. non bulky tumor on loco regional and distant failure. Conclusions: Longer radiotherapy completion time was found to be associated with diminished survival outcomes for patients treated radically for carcinoma cervix. The significance of this observed association requires further investigation & correction to keep OTT as short as possible. No significant financial relationships to disclose.

T1-T2N0 Squamous Cell Carcinoma of the Glottic Larynx Treated With Radiation Therapy

2001 ◽  
Vol 19 (20) ◽  
pp. 4029-4036 ◽  
Author(s):  
William M. Mendenhall ◽  
Robert J. Amdur ◽  
Christopher G. Morris ◽  
Russell W. Hinerman
Keyword(s):  
Radiation Therapy ◽  
Local Control ◽  
Treatment Time ◽  
Survival Rates ◽  
Glottic Carcinoma ◽  
Overall Treatment Time ◽  
Poorly Differentiated ◽  
Histologic Differentiation ◽  
Lost To Follow Up

PURPOSE: The end results after radiation therapy for T1-T2N0 glottic carcinoma vary considerably. We analyze patient-related and treatment-related parameters that may influence the likelihood of cure. PATIENTS AND METHODS: Five hundred nineteen patients were treated with radiation therapy and had follow-up for ≥ 2 years. Three patients who were disease-free were lost to follow-up at 7 months, 21 months, and 10.5 years. No other patients were lost to follow-up. RESULTS: Local control rates at 5 years after radiation therapy were as follows: T1A, 94%; T1B, 93%; T2A, 80%; and T2B, 72%. Multivariate analysis of local control revealed that the following parameters significantly influenced this end point: overall treatment time (P < .0001), T stage (P = .0003), and histologic differentiation (P = .013). Patients with poorly differentiated cancers fared less well than those with better differentiated lesions. Rates of local control with laryngeal preservation at 5 years were as follows: T1A and T1B, 95%; T2A, 82%; and T2B, 76%. Cause-specific survival rates at 5 years were as follows: T1A and T1B, 98%; T2A, 95%; and T2B, 90%. One patient with a T1N0 cancer and three patients with T2N0 lesions experienced severe late radiation complications. CONCLUSION: Radiation therapy cures a high percentage of patients with T1-T2N0 glottic carcinomas and has a low rate of severe complications. The major treatment-related parameter that influences the likelihood of cure is overall treatment time.

scholarly journals Role of interstitial brachytherpy using template (mupit) in locally advanced carcinoma cervix

2016 ◽  
Author(s):  
Ashish Bhange ◽  
Abhishek Gulia ◽  
Anirudh Punnakal ◽  
Anil Kumar Anand ◽  
Anil Kumar Bansal ◽  
...  
Keyword(s):  
Local Control ◽  
Residual Disease ◽  
Locally Advanced ◽  
Concurrent Chemotherapy ◽  
Interstitial Brachytherapy ◽  
Carcinoma Cervix ◽  
Advanced Carcinoma ◽  
Needle Position ◽  
Grade 3

Introduction: Locally advanced carcinoma cervix includes stages IIB, IIIA, IIIB and IVA. Interstitial brachytherapy has the potential to deliver adequate dose to lateral parametrium and to vagina. Hence, it is preferable in cases with distorted anatomy, extensive (lower) vaginal wall involvement, bulky residual disease post EBRT and parametrium involvement upto lateral pelvic wall. Aim and Objective: To determine clinical outcome and complications (acute and chronic) in locally advanced carcinoma cervix, treated with interstitial brachytherapy using template (MUPIT - Martinez universal perineal interstitial template). Materials and Methods: This study is a retrospective analysis of 37 cases of locally advanced carcinoma cervix (stage IIB-2, IIIB-30, IVA-5), treated with EBRT (dose-median 45Gy/25#) ± concurrent chemotherapy (CCT) - Inj. Cisplatin/Inj Carboplatin, followed by interstitial brachytherapy using MUPIT from December 2009 to June 2015. Initial treatment with EBRT ± CCT was followed by intertstitial brachytherapy. Under spinal anaesthesia and epidural analgesia, MUPIT application was done. Straight and divergent needles (median 26, range 19-29) were inserted to cover parametrium adequately. Needle position was verified with planning CT scan and Brachytherapy planning was done. Dose was normalized to 5 mm box surface from outermost needle with optimization of dose to OAR (Bladder, Rectum and Sigmoid colon). Prescription dose –25Gy in 5#. Treatment was delivered by Microselectron HDR using Ir192 source. Treatment fractions were delivered twice daily with min 6 Hrs. gap in-between fractions. Results: The median duration of follow-up was 25 months. Local control was achieved in 28 patients with residual disease in 7 patients and local recurrence in 2 patients. 10 patients had acute lower GI toxicity {Grade1 (n=6), Grade 2 (n=4)}, 2 patients had acute Grade 1 bladder toxicity. 1 patient had grade 3 and 1 patient had grade 4 chronic bladder toxicity. Chronic rectal toxicity was seen in 10 patients {Grade 2 (n=4), Grade 3 (n=4), Grade 4 (n=2)}. Conclusion: Local control was achieved in 28/37 patients (75.6%) and overall survival rate of 81.1% at median follow up of 25 months in patients with locally advanced carcinoma cervix and unfavorable prognostic factors.

Cetuximab versus cisplatin concurrent with IMRT in locally advanced head and neck cancer (LAHNC)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17030-e17030 ◽  
Author(s):  
S. L. Galper ◽  
H. Deshpande ◽  
M. G. Rose ◽  
R. H. Decker
Keyword(s):  
Treatment Time ◽  
Randomized Study ◽  
Locally Advanced ◽  
Late Toxicity ◽  
Distant Metastases ◽  
Overall Treatment Time ◽  
Tumor Registry ◽  
Altered Fractionation ◽  
N Stage

e17030 Background: Concurrent chemoradiation of LAHNC with cetuximab or cisplatin improves survival. The purpose of this study is to compare cetuximab chemoradiation (ExRT) with cisplatin chemoradiation (ChRT) in patients treated with IMRT. Methods: Between January 2005 and August 2008, 24 patients with LAHNC were treated with definitive chemoradiation utilizing IMRT. ExRT was reserved for those whose age or comorbidities precluded ChRT. 15 patients were treated with ChRT and 9 patients were treated with ExRT. Patient charts and Tumor Registry data were reviewed for acute and late toxicity and for local/regional failure (LRF), distant metastases and death. Results: The ExRT cohort was significantly older (median age 71 vs 58, p=0.005) and had more larynx/hypopharynx primaries (44% vs 27%). The cohorts were otherwise balanced with respect to T- and N-stage. Median follow-up for the ExRT and ChRT cohorts was 11 and 12 months, respectively. Overall treatment time in compliant patients was lower in ExRT patients (46 vs 50 days, p=0.05), reflecting increased use of accelerated radiation fractionation (66% vs 40%). See Table for toxicity outcomes. There was a trend toward increased ≥G3 acute mucositis in the ExRT group (p=0.07). However, there was less weight loss (p=0.05). There were similar acute epidermitis and hospitalizations for malnutrition/hydration rates and a nonsignificant decrease in prolonged mucosal toxicity. 1 patient developed skin necrosis and another osteoradionecrosis in the ChRT group. 1-year freedom from LRF was 89% in the ChRT group vs 56% in the ExRT group (p=0.07). Overall survival (OS) at 1 year was 100% (ChRT) vs 88% (ExRT). Conclusions: ExRT showed a trend toward worse acute mucosal toxicity but not late toxicity despite increased rates of altered fractionation with a higher daily dose. ExRT was associated with worse LRC and OS. A randomized study would best compare outcomes and toxicity profiles. Until such analysis, cetuximab should be reserved for patients unable to tolerate ChRT. [Table: see text] No significant financial relationships to disclose.

scholarly journals Adjuvant Hysterectomy for Cervical Cancer Patients Treated with Chemoradiation Therapy: A Systematic Review on the Pathology-Proven Residual Disease Rate

Cancers ◽  
2021 ◽  
Vol 13 (24) ◽  
pp. 6190
Author(s):  
Kim van Kol ◽  
Renée Ebisch ◽  
Jurgen Piek ◽  
Maaike Beugeling ◽  
Tineke Vergeldt ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cervical Cancer ◽  
Survival Rate ◽  
Residual Disease ◽  
Survival Rates ◽  
Chemoradiation Therapy ◽  
Disease Rate ◽  
Cochrane Database ◽  
Adjuvant Hysterectomy

Objective: To determine the incidence of pathology-proven residual disease in adjuvant hysterectomy specimens in patients with cervical cancer, treated with chemoradiation therapy. Secondly, to assess a possible association for pathology-proven residual disease regarding the time between chemoradiation therapy and adjuvant hysterectomy. Additionally, the survival rate and complication rate were assessed. Methods: PubMed, EMBASE, and the Cochrane database were searched from inception up to 8 March 2021. Results: Of the 4601 screened articles, eleven studies were included. A total of 1205 patients were treated with chemoradiation therapy and adjuvant hysterectomy, ranging from three to twelve weeks after chemoradiation therapy. A total of 411 out of 1205 patients (34%) had pathology-proven residual disease in the adjuvant hysterectomy specimen. There was no association found in the time between chemoradiation therapy and adjuvant hysterectomy. Follow-up ranged from 2.4 to 245 months, during which 270 patients (22%) relapsed, and 298 patients (27%) were deceased. A total of 202 (35%) complications were registered in 578 patients. Conclusion: there is no association found in the time between chemoradiation therapy and residual disease on adjuvant hysterectomy specimens. The survival rates after chemoradiation therapy and adjuvant hysterectomy are suboptimal, while the risk of complications after adjuvant hysterectomy is high.

scholarly journals Reduced Time and Toxicity with SIB IMRT in Carcinoma Breast

2015 ◽  
Vol 3 (3) ◽  
pp. 561-565
Author(s):  
Rashi Agrawal ◽  
Sandeep Agrawal ◽  
Sudarsan De
Keyword(s):  
Treatment Duration ◽  
Treatment Time ◽  
Breast Conservation ◽  
Simultaneous Integrated Boost ◽  
Breast Conservation Surgery ◽  
Overall Treatment Time ◽  
Image Guided Radiotherapy ◽  
Carcinoma Breast ◽  
Integrated Boost

Introduction: To reduce treatment duration, we are treating our carcinoma breast patients with simultaneous integrated boost radiotherapy after breast conservation surgery. Here we are presenting our experience at median follow up of three years. Material and methods: Patients having at least 6 months of follow up after completion of radiotherapy were evaluated .All patients were treated with intensity modulated image guided radiotherapy technique. Dose prescribed to clinical target volume breast was 50 Gy in 25 fractions and CTV boost was 60 Gy in 25 fractions. Results: Median age of our patients was 49 years. Five patients (10.2%) had acute grade 2 skin toxicity and all other (89.7%) grade 1.Grade 2 toxicity was noted in patients with pendulous and bulky breast. Average treatment duration was 34 days (range 32-56 days). Median follow up is three years after completion of radiotherapy. Twenty six (53.06 %) patients had late grade zero and twenty three (46.9% ) grade 1 skin reactions.Conclusion: With simultaneous integrated boost in carcinoma breast patients, overall treatment time can be reduced without increasing early and late toxicities. Implementation is easy with decreased replanning workload. Henceforth SIB can be a feasible option for early breast cancer patients.Int J Appl Sci Biotechnol, Vol 3(3): 561-565

DeCIDE: A phase III randomized trial of docetaxel (D), cisplatin (P), 5-fluorouracil (F) (TPF) induction chemotherapy (IC) in patients with N2/N3 locally advanced squamous cell carcinoma of the head and neck (SCCHN).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5500-5500 ◽  
Author(s):  
Ezra E. W. Cohen ◽  
Theodore Karrison ◽  
Masha Kocherginsky ◽  
Chao H Huang ◽  
Mark Agulnik ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Survival Rates ◽  
Phase Iii ◽  
High Survival ◽  
Open Label ◽  
Free Survival ◽  
Prior Therapy ◽  
Distant Failure ◽  
Grade 3

5500 Background: IC is associated with lower distant failure (DF) rates in SCCHN but an improvement in overall survival (OS) has not been validated. The goal of this trial was to determine whether IC prior to chemoradiotherapy (CRT) improves survival compared to CRT alone. Methods: In this phase 3, open-label trial, subjects with pathologically confirmed SCCHN; N2/N3 disease without metastases; no prior therapy; KPS ³ 70%; and intact organ function were randomized to CRT alone (CRT arm) [5 days of D (25 mg/m2), F (600 mg/m2), hydroxyurea (500 mg BID), and RT (150 cGy BID) followed by a 9 day break] or to 2 cycles of IC [D (75 mg/m2), P (75 mg/m2), F (750 mg/m2 day 1-5)] followed by the same CRT (IC arm). Primary endpoint was OS. Secondary endpoints included DF free survival, failure pattern, and recurrence-free survival (RFS). 280 subjects provided 80% power to detect a hazard ratio HR=0.5 for OS (a=0.05). Results: 280 subjects were accrued from 2004-09 with minimum follow-up 24 months. Of 142 patients randomized to IC, 91% received 2 cycles and 87% continued to CRT. Treatment adherence during CRT was high for docetaxel and hydroxyurea, but fewer than 75% of the patients received target dose of 5FU in both arms. RT was delivered without major deviations in 94% and 95% of patients on IC and CRT arms, respectively. The most common grade 3-4 toxicities during IC were febrile neutropenia (9%) and mucositis (8%), and during CRT (both arms combined) they were mucositis (45%), dermatitis (19%), and leukopenia (17%). Only grade 3-4 leukopenia and neutropenia rates were significantly higher in IC (p=0.002 and p=0.02, respectively). Table shows efficacy. Conclusions: High survival rates were observed in both arms. Further analysis and follow-up may provide insight into why the significant decrease in DF did not translate into improved OS. [Table: see text]

Minimal Residual Disease (MRD) in Childhood Acute Lymphoblastic Leukemia (ALL). Correlation with Prognostic Factors and Outcome

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4848-4848
Author(s):  
Anna Paisiou ◽  
Georgios Paterakis ◽  
Nikolaos Tsagarakis ◽  
Nektaria Kentrou ◽  
Vassilios Papadakis ◽  
...  
Keyword(s):  
High Risk ◽  
Treatment Time ◽  
Residual Disease ◽  
Childhood All ◽  
Time Points ◽  
Standardized Treatment ◽  
Group A ◽  
Group B ◽  
Time Point

Abstract Aim: The aim of this study was the prospective evaluation of MRD during childhood ALL therapy and its correlation with specific prognostic criteria of ALL-BFM 95 protocol and with patient outcome. Patients/Methods: 127 children (49 girls) with ALL were studied during the period 1999–2008. The median age at diagnosis was 9,32 years (range, 0,6–16,48). All patients were diagnosed in the same center and treated uniformly with the ALL-BFM 95 protocol, modified in two therapeutic branches, medium and high risk, as we have published previously. We used three or five colours’ flow cytometric panels for MRD quantification at sequential standardized treatment time-points: at day 15 of induction (T1), at day 33 (T2) of induction, before consolidation (T3), before re-induction (T4), before maintenance (T5), at maintenance completion (T6). Additionally for the high risk patients, 6 more determinations before each consolidation treatment cycle were performed. The median follow-up time was 48,4 months (range, 1,7–110,3). For statistical analysis, descriptive statistics and Kaplan-Meier were used. Results: Immunophenotypical analysis resulted in 119 patients with ALL of B-origin and 8 of T-origin. Median WBC at diagnosis was 10×109/lt, while extra-BM infiltration was found in 9 children. According to ALL-BFM 95 protocol’s criteria: 40 patients were fulfilling the criteria of the standard risk (SR), 61 of medium (MR) and 26 of high risk (HR), respectively, and therapeutically were divided into two groups: A (101 patients, SR+MR) and B (26 patients, HR). MRD was detected in: 59/123 patients at treatment time-point (T1) (39/59 from group A, of which 26/39 with high MRD levels, and 20/59 from group B, all with high MRD levels). In time-point (T2), disease was detected in 19/124: 5/19 from group A (3/5 high MRD levels), 14/19 from group B (11/14 high MRD levels). At treatment-point (T3), 3/127 had detectable disease (all from group B). None of the patients of group A had minimal residual disease at the following time-points, while only 2 patients of group B had persistent presence of MRD. In total, 14/127 children relapsed (4/SR, 2/MR, 8/HR), with significant levels of MRD in 7 (6/7 HR) and 4 (all HR) patients, at time-point (T1) and (T2), respectively. Among all, 114 children survived (CR1: 110, CR2: 4), while 13 children died (9/disease, 4/therapy-related toxicity). Conclusions: Our results suggest that MRD detection in continuous standardized treatment time-points of childhood ALL correlates with shorter disease free (DFS) and overall survival (OS), however in our cohort there was no sufficient evidence of MRD independency as prognostic factor (cox-regression analysis) compared to the classical prognostic criteria of the ALL-BFM 95. The enlargement of the group of patients and the expansion of the follow-up period will lead to more reliable conclusions.

scholarly journals Head and Neck Cancer a Single Institution Experience: King Abdulaziz University

2015 ◽  
Vol 22 (3) ◽  
pp. 9-17
Author(s):  
Rolina K Al-Wassia ◽  
Nisreen A. Awad ◽  
Shadi S. Al-Khayyat ◽  
Atlal M. Abusanad ◽  
Hani Z. Al-Marzouki ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Survival Rates ◽  
Treatment Modalities ◽  
Clinical Practices ◽  
Hospital Data ◽  
Intensity Modulated ◽  
Regional Control

The purpose of this study is to assess the loco-regional control and overall survival in head and neck cancer patients, as well as evaluate the clinical benefit of intensity-modulated radiotherapy implemented in 2011 at our Hospital. Data of 117 patients between 2007 and 2014 was reviewed retrospectively. Cumulative survival and disease control rates were calculated by Kaplan-Meier product-limit actuarial method. Loco-regional control and survival rates for intensity modulated and three-dimensional conformal radiotherapy were compared by a logistic regression test. After a median follow-up of 12 months, 53 (51%) patients who underwent radical radiotherapy were free of disease, 43 (42%) with disease, and seven (7%) unknown. During this time, 31 (26%) patients died from the disease. Using actuarial estimates for the two-year follow-up, this study found that significant gains in survival were obtained by switching treatment modalities. The benchmarking gives reassurance that our results are comparable to the best clinical practices internationally.  

What Is the Frequency of Transplant-Eligible Multiple Myeloma Patients Being Cured? the Impact of an MGUS-like Signature at Diagnosis and MRD-Negativity

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 725-725 ◽  
Author(s):  
Bruno Paiva ◽  
Maria Belen Vidriales ◽  
Noemi Puig ◽  
Teresa Cedena ◽  
Lourdes Cordon ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Binding Site ◽  
Residual Disease ◽  
Limit Of Detection ◽  
Survival Rates ◽  
Progression Free Survival ◽  
Classification Model ◽  
The Impact

Abstract Introduction: Although multiple myeloma (MM) is typically described as an incurable disease, it has been shown in recent years that a small fraction of patients may reach more than 10-years progression-free survival (PFS), which is considered as the minimum threshold to identify patients in "operational cure". However, because of the scarcity of available data there is significant lack of knowledge in MM regarding the frequency of cases attaining operational cure, nor the existence of biomarkers that could prospectively predict such curability. Methods: Herein, we sought to define the frequency as well as the biomarkers predictive of operational cure in a large series of uniformly-treated transplant-eligible patients enrolled in the PETHEMA/GEM2000 protocol (VBMCP/VBAD followed by HDT/ASCT and 2 years of maintenance with interferon and prednisone). Patients' follow-up was updated at the time of abstract submission, and the median follow-up of the series is now of 12-years. We used an automated multiparameter flow cytometric (MFC) classification model focused on the analysis of the bone marrow plasma-cell compartment to identify among newly diagnosed symptomatic MM those with MGUS-like vs. MM-like phenotypic signatures. Minimal residual disease (MRD) was monitored using a first-generation 4-color MFC assay (CD38-FITC / CD56-PE / CD19-PerCPCy5.5 / CD45-APC) with a limit of detection of 10-4. PFS and overall survival (OS) were measured from the time of diagnosis. Results: From a total of 1075 patients enrolled in the GEM2000 protocol, 763 were eligible for this analysis because they either relapsed or died during the first 10-years from diagnosis (n=666; 87%), or remained progression-free and alive for more than 10-yers (n=97; 13%); accordingly, all patients remaining progression-free and alive but for which the follow-up was inferior to 10-years were excluded from the analysis. We then investigated the biomarkers that could help to identify patients reaching operational cure after HDT/ASCT. As compared to the vast majority of cases, patients reaching >10-years PFS (13%) had significantly less frequent anemia (76% vs. 60%, respectively; P=.002), as well as more frequent Durie-Salmon stage IA (14% vs. 6%; P=.004), MGUS-like signature as determined by the automated MFC algorithm (28% vs. 6%; P<.001), complete response (CR) after HDT/ASCT (51% vs. 35%; P=.003), and MRD-negativity by MFC (72% vs. 31%; P<.001). Other biomarkers such as ISS, LDH, ploidy and proliferation were not significantly different among patients reaching >10-years PFS vs. those who relapsed earlier. On multivariate analysis, only the presence of an MGUS-like signature at baseline (P=.04; HR: 3.9) and MRD-negativity at day+100 after HDT/ASCT (P=.006; HR: 6.3) emerged as independent predictive markers for >10-years PFS; anemia, Durie-Salmon and CR status were not retained in the logistic regression model. Accordingly, patients with an MFC-defined baseline MGUS-like signature reaching MRD-negativity after HDT/ASCT (n=14) had a median PFS of 10-years and a 10-year OS rate of 79%, which were significantly superior to those observed among cases with MM-like signatures being MRD-negative (n=54) or positive (n=99) after therapy [median PFS of 6 and 3 years (P<.001); 10-year overall survival rates of 55% and 19% (P<.001)]. Conclusions: We demonstrated that operational cure (i.e.: >10-years PFS) was possible for 13% of transplant-eligible MM patients before the era of novel agents. Curability rates were particularly frequent among patients with a benign phenotypic signature at diagnosis and MRD negativity after HDT/ASCT, suggesting a remarkable clinical benefit of attaining deep remissions after intensive treatment for patients with early MM. Disclosures Paiva: Sanofi: Consultancy; Janssen: Consultancy; Millenium: Consultancy; Onyx: Consultancy; BD Bioscience: Consultancy; EngMab AG: Research Funding; Binding Site: Consultancy; Celgene: Consultancy. Puig:The Binding Site: Consultancy; Janssen: Consultancy. Mateos:Takeda: Consultancy; Celgene: Consultancy, Honoraria; Onyx: Consultancy; Janssen-Cilag: Consultancy, Honoraria. San Miguel:Celgene: Honoraria; Bristol-Myers Squibb: Honoraria; Onyx: Honoraria; Sanofi-Aventis: Honoraria; Novartis: Honoraria; Millennium: Honoraria; Janssen-Cilag: Honoraria.

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