Clinical correlations between first line of therapy and overall survival in patients with multiple myeloma
Multiple myeloma is a hematological cancer of matured B lymphocytes (plasma cells). In an attempt to track patients’ disease progression and response to treatment, the Multiple Myeloma Research Foundation (MMRF) created the MMRF CoMMpass Study with the goal of mapping 1000 patients’ genomic profiles to their clinical data. We analyzed the currently available clinical data and categorized patients based on their first line of therapy. Our goal was to correlate different treatment regimens with the overall survival of patients within those groups, with the purpose of revealing optimal treatment regimens.
We used RStudio to visualize each patient’s clinical data for the IA9 and IA10 cohorts in order to bin each patient according to their first line of treatment. Approximately 1000 plots were visually inspected to correctly define each patient’s first line of treatment. Multiple iterations and randomized spot checks of ~ 5% were performed in order to ensure quality of analysis. The four most common first line regimens (representing ~ 75% of patients) were: Lenalidomide-Dexamethasone (82), Bortezomib-Dexamethasone (111), Cyclophosphamide-Bortezomib-Dexamethasone (170), Lenalidomide-Bortezomib-Dexamethasone (355). Density plots were then constructed to correlate overall survival within each treatment group.
Analysis of the IA9 cohort suggested patients have a longer overall survival when their first line of therapy was a combination of Lenalidomide, Bortezomib, and Dexamethasone. However, when we censored the data to exclude patients still undergoing treatment, the optimal regimen was a Cyclophosphamide, Bortezomib, and Dexamethasone triplet. These same findings were apparent in the most recent IA10 cohort data. However, the MMRF CoMMpass Study is still ongoing and future data releases are necessary for statistically significant conclusions. With subsequent data releases, visualization with Kaplan Meier plots will delineate any significant differences in overall survival based on currently prescribed myeloma treatments.