EMN 2021 | FORTE: impact of gain and amplification of 1q in myeloma
Mattia D’Agostino, MD, University of Torino, Turin, Italy, gives an overview of his talk at EMN 2021 on the prognostic impact of gain and amplification of 1q in newly diagnosed multiple myeloma patients in the FORTE trial (NCT02203643). 1q amplification (four or more copies of 1q) or gain (three copies of 1q) is a prognostic factor in multiple myeloma, however it was proposed that a higher number of copies of 1q may predict worse outcomes. The study found that having four or more copies of 1q is a predictor of very poor progression-free survival (PFS) and overall survival (OS) despite treatment with carfilzomib, however, reaching measurable residual disease (MRD) negativity may mitigate this risk. Carfilzomib plus lenalidomide plus dexamethasone (KrD) induction followed by autologous stem cell transplantation (ASCT) abrogated the PFS disadvantage observed in patients with three copies of 1q. This interview took place during the 2021 European Myeloma Network (EMN) congress.
Transcript (edited for clarity)
In this work we analyzed the prognostic impact of 1q amplification, defined as at least four copies of 1q, or 1q gain, defined as three copies of 1q, in newly diagnosed multiple myeloma patients. As you know, a 1q amplification or gain is a prognostic factor in newly diagnosed multiple myeloma, however, the number of copies may predict a worse outcome.
And in this work, we have observed that patients with an amplification of 1q have a medium PFS of only 21 months, that is significantly shorter than in 1q patient and patients without 1q alterations...
In this work we analyzed the prognostic impact of 1q amplification, defined as at least four copies of 1q, or 1q gain, defined as three copies of 1q, in newly diagnosed multiple myeloma patients. As you know, a 1q amplification or gain is a prognostic factor in newly diagnosed multiple myeloma, however, the number of copies may predict a worse outcome.
And in this work, we have observed that patients with an amplification of 1q have a medium PFS of only 21 months, that is significantly shorter than in 1q patient and patients without 1q alterations. And the overall survival of these patients was significantly worse as well.
Subgroup analysis showed that despite the use of carfilzomib first-line, 1q patients are still high-risk. However, amplification 1q patients reaching a very good response, defined as MRD-negativity may achieve a good PFS. So, in conclusion, we showed that having more than four copies of the amplifi-, of 1q predicts superior PFS and OS, despite carfilzomib use upfront, however, reaching MRD-negativity may mitigate the risk conferred by having four or more copies of 1q.
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