High cereblon expression is associated with better survival in patients with newly diagnosed multiple myeloma treated with thalidomide maintenance
Mené sur 96 patients atteints d'un myélome multiple récemment diagnostiqué, cet essai montre qu'un niveau élevé d'expression du gène codant pour la protéine céréblon est associé à la réponse à un traitement d'entretien par thalidomide et à un meilleur pronostic
Recently, cereblon (CRBN) expression was described to be essential for the activity of Thalidomide and Lenalidomide. We investigated if clinical efficacy of Thalidomide in multiple myeloma is associated with CRBN expression in myeloma cells. Patients with newly diagnosed multiple myeloma were included in the HOVON-65/GMMG-HD4 trial, in which post-intensification treatment in one arm consisted of daily Thalidomide 50 mg for 2 years. Gene expression profiling, determined at the start of the trial, was available for 96 patients who started Thalidomide maintenance. In this patient set, increase of CRBN gene expression was significantly associated with longer progression free survival (p=0.005). In contrast, no association between CRBN expression and survival was observed in the arm with Bortezomib maintenance. We conclude that CRBN expression may be associated with clinical efficacy of Thalidomide. This trial has been registered at www.trialregister.nl as NTR213 EudraCT no. 2004-000944-26 ISRCTN: 64455289
Blood , résumé, 2012