Publication details

Methodology of a Novel Risk Stratification Algorithm for Patients with Multiple Myeloma in the Relapsed Setting

Authors

BOUWMEESTER Walter BRIGGS Andrew VAN HOUT Ben HAJEK Roman GONZALEZ-MCQUIRE Sebastian CAMPIONI Marco DECOSTA Lucy BROŽOVÁ Lucie

Year of publication 2019
Type Article in Periodical
Magazine / Source ONCOLOGY AND THERAPY
MU Faculty or unit

Faculty of Medicine

Citation
Web http://dx.doi.org/10.1007/s40487-019-00100-5
Doi http://dx.doi.org/10.1007/s40487-019-00100-5
Keywords Algorithm; Multiple myeloma; Prognostic model; Risk; Survival
Description Introduction Risk stratification tools provide valuable information to inform treatment decisions. Existing algorithms for patients with multiple myeloma (MM) were based on patients with newly diagnosed disease, and these have not been validated in the relapsed setting or in routine clinical practice. We developed a risk stratification algorithm (RSA) for patients with MM at initiation of second-line (2L) treatment, based on data from the Czech Registry of Monoclonal Gammopathies. Methods Predictors of overall survival (OS) at 2L treatment were identified using Cox proportional hazards models and backward selection. Risk scores were obtained by multiplying the hazard ratios for each predictor. The K-adaptive partitioning for survival (KAPS) algorithm defined four groups of stratification based on individual risk scores. Results Performance of the RSA was assessed using Nagelkerke's R-2 test and Harrell's concordance index through Kaplan-Meier analysis of OS data. Prognostic groups were successfully defined based on real-world data. Use of a multiplicative score based on Cox modeling and KAPS to define cut-off values was effective. Conclusion Through innovative methods of risk assessment and collaboration between physicians and statisticians, the RSA was capable of stratifying patients at 2L treatment by survival expectations. This approach can be used to develop clinical decision-making tools in other disease areas to improve patient management. Funding Amgen Europe GmbH.

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