Evidence map›Paper›PMID 38915117›Full record

ArticleJournal of hematology & oncology2024

Individualized dynamic frailty-tailored therapy (DynaFiT) in elderly patients with newly diagnosed multiple myeloma: a prospective study.

Yingjie Zhang, Xinyue Liang, Weiling Xu, Xingcheng Yi, Rui Hu, Xintian Ma, Yurong Yan, Nan Zhang, Jingxuan Wang, Xiaoxiao Sun and 6 more

Abstract readLetter
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hematology & oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Trial
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Yingjie Zhang *Department of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Xinyue Liang *Department of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Weiling XuDepartment of Radiology, First Hospital of Jilin University, Changchun, Jilin, China.
Xingcheng YiLaboratory of Cancer Precision Medicine, First Hospital of Jilin University, 519 Dongminzhu Street, Changchun, Jilin, 130061, China.
Rui HuDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Xintian MaDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Yurong YanDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Nan ZhangDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Jingxuan WangDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Xiaoxiao SunDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Yufeng ZhuDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Mengru TianDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China.
Maozhuo LanLaboratory of Cancer Precision Medicine, First Hospital of Jilin University, 519 Dongminzhu Street, Changchun, Jilin, 130061, China.
Mengtuan LongLaboratory of Cancer Precision Medicine, First Hospital of Jilin University, 519 Dongminzhu Street, Changchun, Jilin, 130061, China.
Yun DaiLaboratory of Cancer Precision Medicine, First Hospital of Jilin University, 519 Dongminzhu Street, Changchun, Jilin, 130061, China. daiyun@jlu.edu.cn.ORCID 0000-0003-2285-0818
Fengyan JinDepartment of Hematology, First Hospital of Jilin University, 71 Xinmin Street, Changchun, Jilin, 130012, China. fengyanjin@jlu.edu.cn.ORCID 0000-0003-2288-556X

Funding

Jilin Provincial Scientific and Technological Development Program 20190201042JCJilin Provincial Scientific and Technological Development Program 20190201163JCNational Natural Science Foundation of China 81471165National Natural Science Foundation of China 81670189
6 · The paper itself

Abstract

It remains a substantial challenge to balance treatment efficacy and toxicity in geriatric patients with multiple myeloma (MM), primarily due to the dynamic nature of frailty. Here, we conducted a prospective study to evaluate the feasibility and benefits of dynamic frailty-tailored therapy (DynaFiT) in elderly patients. Patients with newly diagnosed MM (aged ≥ 65 years) received eight induction cycles of bortezomib, lenalidomide, and dexamethasone (daratumumab was recommended for frail patients), with treatment intensity adjusted according to longitudinal changes in the frailty category (IMWG-FI) at each cycle. Of 90 patients, 33 (37%), 16 (18%), and 41 (45%) were fit, intermediate fit, and frail at baseline, respectively. Of 75 patients who had geriatric assessment at least twice, 28 (37%) experienced frailty category changes at least once. At analysis, 15/26 (58%) frail patients improved (27% became fit and 31% became intermediate fit), 4/15 (27%) intermediate fit patients either improved or deteriorated (two for each), and 6/30 (20%) fit patients deteriorated. During induction, 34/90 (38%) patients discontinued treatment, including 10/33 (30%) fit, 4/16 (25%) intermediate fit, and 20/41 (49%) frail; 14/40 (35%) frail patients discontinued treatment within the first two cycles, mainly because of non-hematologic toxicity (mostly infections). For fit, intermediate-fit, and frail patients, the overall response rate was 100%, 93%, and 73%, respectively; one-year overall survival was 90%, 75%, and 54%, respectively. Therefore, the individualized DynaFiT is feasible and promising for heterogeneous elderly patients.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsDexamethasoneFrailtyLenalidomideMultiple MyelomaAgedAged, 80 and overAntibodies, MonoclonalBortezomibFemaleFrail ElderlyGeriatric AssessmentHumansMalePrecision MedicineProspective StudiesAntibodies, MonoclonalBortezomibdaratumumabDexamethasoneLenalidomideDynamicsElderlyFrailtyFrailty-tailored therapyMultiple myeloma

Identifiers

PMID38915117
PMCPMC11197371

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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.