Trial reportBlood advances2020
Prognostic and predictive performance of R-ISS with SKY92 in older patients with multiple myeloma: the HOVON-87/NMSG-18 trial.
Trial report in Blood advances, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
19 citing papers in PubMed, 33 citations in OpenAlex.
- Age-related disparities in treatment and outcomes for newly diagnosed multiple myeloma: a population-based study.Haematologica · 2025Article
- The past, present, and future of myeloma staging and risk prognostication.The oncologist · 2025Review
- Individualized dynamic risk assessment and treatment selection for multiple myeloma.British journal of cancer · 2025Article
- Combining SKY92 gene expression profiling and FISH (according to R2-ISS) defines ultra-high-risk Multiple Myeloma.HemaSphere · 2025Article
- Characterization of driver mutations identifies gene signatures predictive of prognosis and treatment sensitivity in multiple myeloma.The oncologist · 2024Article
- Multi-dimensional scaling techniques unveiled gain1q&loss13q co-occurrence in Multiple Myeloma patients with specific genomic, transcriptional and adverse clinical features.Nature communications · 2024Article
- A rational approach to functional high-risk myeloma.Hematology. American Society of Hematology. Education Program · 2023Review
- Heterogeneity in long-term outcomes for patients with Revised International Staging System stage II, newly diagnosed multiple myeloma.Haematologica · 2023Article
- Current Main Topics in Multiple Myeloma.Cancers · 2023Review
- ERBB1/EGFR and JAK3 Tyrosine Kinases as Potential Therapeutic Targets in High-Risk Multiple Myeloma.Onco · 2022Article
- Prognostic Stratification of Multiple Myeloma Using Clinicogenomic Models: Validation and Performance Analysis of the IAC-50 Model.HemaSphere · 2022Article
- Perspectives on the Risk-Stratified Treatment of Multiple Myeloma.Blood cancer discovery · 2022Article
- High-risk disease in newly diagnosed multiple myeloma: beyond the R-ISS and IMWG definitions.Blood cancer journal · 2022Review
- Prognostic gene expression analysis in a retrospective, multinational cohort of 155 multiple myeloma patients treated outside clinical trials.International journal of laboratory hematology · 2022Article
- Gene Expression Profiling in Multiple Myeloma: Redefining the Paradigm of Risk-Adapted Treatment.Frontiers in oncology · 2022Review
- Risk Stratification Before and During Treatment in Newly Diagnosed Multiple Myeloma: From Clinical Trials to the Real-World Setting.Frontiers in oncology · 2022Review
- Correlations between apparent diffusion coefficient values of WB-DWI and clinical parameters in multiple myeloma.BMC medical imaging · 2021Article
- Multiple Myeloma: Heterogeneous in Every Way.Cancers · 2021Review
- Gene expression profiling as a prognostic tool in multiple myeloma.Cancer drug resistance (Alhambra, Calif.) · 2021Review
Corrections and comments
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Authors and funding
18 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The standard prognostic marker for multiple myeloma (MM) patients is the revised International Staging System (R-ISS). However, there is room for improvement in guiding treatment. This applies particularly to older patients, in whom the benefit/risk ratio is reduced because of comorbidities and subsequent side effects. We hypothesized that adding gene-expression data to R-ISS would generate a stronger marker. This was tested by combining R-ISS with the SKY92 classifier (SKY-RISS). The HOVON-87/NMSG-18 trial (EudraCT: 2007-004007-34) compared melphalan-prednisone-thalidomide followed by thalidomide maintenance (MPT-T) with melphalan-prednisone-lenalidomide followed by lenalidomide maintenance (MPR-R). From this trial, 168 patients with available R-ISS status and gene-expression profiles were analyzed. R-ISS stages I, II, and III were assigned to 8%, 75%, and 7% of patients, respectively (3-year overall survival [OS] rates: 80%, 65%, 33%, P = 8 × 10-3). Using the SKY92 classifier, 13% of patients were high risk (HR) (3-year OS rates: standard risk [SR], 70%; HR, 28%; P < .001). Combining SKY92 with R-ISS resulted in 3 risk groups: SKY-RISS I (SKY-SR + R-ISS-I; 15%), SKY-RISS III (SKY-HR + R-ISS-II/III; 11%), and SKY-RISS II (all other patients; 74%). The 3-year OS rates for SKY-RISS I, II, and III are 88%, 66%, and 26%, respectively (P = 6 × 10-7). The SKY-RISS model was validated in older patients from the CoMMpass dataset. Moreover, SKY-RISS demonstrated predictive potential: HR patients appeared to benefit from MPR-R over MPT-T (median OS, 55 and 14 months, respectively). Combined, SKY92 and R-ISS classify patients more accurately. Additionally, benefit was observed for MPR-R over MPT-T in SKY92-RISS HR patients only.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.