Zhongguo shi yan xue ye xue za zhi · 2025
[Clinical Analysis of Ixazomib-Based Chemotherapy Regimens in the Treatment of Newly Diagnosed Multiple Myeloma with 1q21 Amplification].
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Lin Dan-Xia, Zhuang Yan-Hong, Tang Jian, Hu Jia-Sheng
Аннотация
OBJECTIVE: To clarify the prognostic significance of 1q21 amplification in multiple myeloma (MM), and explore the efficacy and prognosis of ixazomib in the treatment of MM patients with 1q21 amplification.
METHODS: A retrospective analysis of clinical data was conducted on 77 patients with newly diagnosed MM who were hospitalized in Zhongshan Hospital, Xiamen University from January 2010 to December 2022. To analyze the clinical features of MM patients with 1q21 amplification, evaluate the mitigation rate and survival treated with ixazomib-based regimens.
RESULTS: Among the 77 newly diagnosed MM patients, 40 patients had 1q21 amplification, while 37 didn't. Multivariate Cox regression analysis revealed that 1q21 amplification was an independent risk factor affecting the prognosis of MM patients (P < 0.05). Compared to patients without 1q21 amplification, those with 1q21 amplification had poorer progression-free survival (PFS) and overall survival (OS) (both P < 0.05). When the 1q21 amplification ratio exceeded 66.7%, both PFS and OS were worse (P < 0.05). There were no statistical differences in the deep remission rate (≥VGPR), overall response rate and PFS between the 1q21 amplification positive and negative groups treated with ixazomib-based regimens (P >0.05), but OS showed a significant difference (P < 0.05). Among the patients who switched to ixazomib treatment from bortezomib, there was a statistically significant difference in the complete response rate (P < 0.05). Compared to other treatment regimens, ixazomib-based regimens resulted in a significant reduction in adverse reactions such as peripheral neuropathy (P < 0.05).
CONCLUSION: Ixazomib-based chemotherapy regimens can overcome the poor prognosis associated with 1q21 amplification and improve mitigation rates and PFS in patients. Ixazomib has low incidence of adverse reactions, good safety profile and prolonged duration of therapy.
METHODS: A retrospective analysis of clinical data was conducted on 77 patients with newly diagnosed MM who were hospitalized in Zhongshan Hospital, Xiamen University from January 2010 to December 2022. To analyze the clinical features of MM patients with 1q21 amplification, evaluate the mitigation rate and survival treated with ixazomib-based regimens.
RESULTS: Among the 77 newly diagnosed MM patients, 40 patients had 1q21 amplification, while 37 didn't. Multivariate Cox regression analysis revealed that 1q21 amplification was an independent risk factor affecting the prognosis of MM patients (P < 0.05). Compared to patients without 1q21 amplification, those with 1q21 amplification had poorer progression-free survival (PFS) and overall survival (OS) (both P < 0.05). When the 1q21 amplification ratio exceeded 66.7%, both PFS and OS were worse (P < 0.05). There were no statistical differences in the deep remission rate (≥VGPR), overall response rate and PFS between the 1q21 amplification positive and negative groups treated with ixazomib-based regimens (P >0.05), but OS showed a significant difference (P < 0.05). Among the patients who switched to ixazomib treatment from bortezomib, there was a statistically significant difference in the complete response rate (P < 0.05). Compared to other treatment regimens, ixazomib-based regimens resulted in a significant reduction in adverse reactions such as peripheral neuropathy (P < 0.05).
CONCLUSION: Ixazomib-based chemotherapy regimens can overcome the poor prognosis associated with 1q21 amplification and improve mitigation rates and PFS in patients. Ixazomib has low incidence of adverse reactions, good safety profile and prolonged duration of therapy.