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Haematological cancer

High-risk SMM — early action required

Nature Reviews Clinical Oncology volume 13, page 529 (2016)Cite this article

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Smouldering multiple myeloma (SMM) is a heterogeneous disorder; for patients with SMM, the risk of progression to multiple myeloma (MM) ranges from very low (1% per year) to high (50–80% in the first 2 years after diagnosis). The standard of care for these patients is observation until they develop myeloma-defining symptoms. The results of the QuiRedex study conducted by María-Victoria Mateos now show that, in patients with high-risk SMM, early treatment leads to delayed progression to MM.

Mateos explains: “early treatment can be offered to the high-risk subgroup of patients because we are able to identify them.” Indeed, two models to predict risk of progression (the Mayo Clinic and Spanish Myeloma Group models) have been validated in prospective trials. In the QuiRedex study, 119 patients with high-risk disease defined by the Spanish Myeloma Group model were randomly allocated to receive either early treatment (median time from diagnosis to enrolment: 3.2–3.5 months) with lenalidomide plus dexamethasone (n = 57) or observation (n = 62).

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References

  1. Mateos, M-V. et al. Lenalidomide plus dexamethasone versus observation in patients with high-risk smouldering multiple myeloma (QuiRedex): long-term follow-up a randomised, controlled, phase 3 trial. Lancet Oncol. http://dx.doi.org/10.1016/S1470-2045(16)30124-3 (2016)

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Authors
  1. Diana Romero
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Mateos, M-V. et al. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N. Engl. J. Med. 369, 438–447 (2013)

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Romero, D. High-risk SMM — early action required. Nat Rev Clin Oncol 13, 529 (2016). https://doi.org/10.1038/nrclinonc.2016.121

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