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Evaluation of the Simplified Score to Predict Early Relapse in Multiple Myeloma (S-ERMM) in the MMRF CoMMpass study
Michael Slade1, Mark Fiala1, Sarah Kelley1
1Washington University School of Medicine, St. Louis, MO, USA.
Background:
Zaccaria and colleagues recently proposed a new risk score to identify patients at high risk for relapse within 18 months of diagnosis (ER18), the Score for Early Relapse in Multiple Myeloma (S-ERMM). We performed external validation of the S-ERMM using data from the CoMMpass study.
Patients And Methods:
Clinical data was obtained from the CoMMpass study. Patients were assigned S-ERMM risk scores and risk categories by the three iterations of the International Staging System (ISS): ISS, R-ISS and R2-ISS. Patients with missing data or early mortality in remission were excluded. Our primary endpoint was the relative predictive ability of the S-ERMM versus other risk scores for ER18 as assessed by area-under-the-curve (AUC).
Results:
476 patients had adequate data to assign all four risk scores. 65%, 25% and 10% were low, intermediate and high risk by S-ERMM. 17% experienced ER18. All four risk scores stratified patients by risk for ER18. S-ERMM (AUC: 0.59 [95% CI 0.53-0.65]) was similar to R-ISS (0.63 [95% CI 0.58-0.69]) and statistically inferior to ISS (0.68 [95% CI 0.62-0.75]) and R2-ISS (0.66 [95% CI 0.61-0.72]) for prediction of ER18. Sensitivity analyses were performed and did not significantly impact results.
Conclusion:
The S-ERMM risk score is not superior to existing risk stratification systems for predicting early relapse in NDMM and further studies are needed to identify the optimal approach.
Insights
The Score for Early Relapse in Multiple Myeloma (S-ERMM) did not outperform existing systems in predicting early relapse in multiple myeloma patients. Further research is needed to find the best risk stratification method.
Area of Science:
- Hematology
- Oncology
- Clinical Research
Background:
- A new risk score, the Score for Early Relapse in Multiple Myeloma (S-ERMM), was proposed to identify high-risk patients for early relapse (ER18).
- External validation of the S-ERMM was performed using data from the CoMMpass study.
Purpose of the Study:
- To externally validate the predictive performance of the S-ERMM for early relapse in multiple myeloma.
- To compare the S-ERMM's ability to predict early relapse against established International Staging System (ISS) iterations.
Main Methods:
- Clinical data from 476 patients in the CoMMpass study were analyzed.
- Patients were assigned risk scores using S-ERMM, ISS, R-ISS, and R2-ISS.
- The primary endpoint was the relative predictive ability for early relapse within 18 months (ER18), assessed by area-under-the-curve (AUC).
Main Results:
- 17% of patients experienced early relapse (ER18).
- All risk scores stratified patients by ER18 risk.
- S-ERMM (AUC: 0.59) showed similar predictive ability to R-ISS (AUC: 0.63) and was inferior to ISS (AUC: 0.68) and R2-ISS (AUC: 0.66).
Conclusions:
- The S-ERMM risk score is not superior to existing risk stratification systems for predicting early relapse in newly diagnosed multiple myeloma (NDMM).
- Further studies are required to determine the optimal risk stratification approach for predicting early relapse in multiple myeloma.
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