NOTE: Although the IMF did not receive permission to post either the audio or the slides from this presentation, we are bringing you a summary written by our medical writer, Lynne Lederman, PhD.
The ISS provides stage-specific prognostic information based on an analysis of 12,000 patients. Of these, genetic information was available for only a small subset. In an effort to improve the predictive ability of ISS, data from patient in the IFM99-02 trial were analyzed. Dr. Avet-Loiseau emphasized that independent prognostic factors associated with event free survival (EFS) and overall survival (OS), including deletion 13, t(4;14) translocation, and high levels of beta-2-microglobulin, were established in patients aged 65 years and younger who were treated with double high dose melphalan therapy, and that the use of bortezomib and the immunomodulatory drugs (IMiDs) thalidomide and lenalidomide, may modify these factors. No data for patients at relapse were available, but information from patients over the age of 65 who were not on high dose therapy will be analyzed. Genetic abnormalities provide powerful prognostic factors, but they need to be evaluated at baseline, and risk assessment needs to be individualized. How to translate this information to the clinical setting remains to be determined.