Impact of t(11;14) on Outcomes in African American and Non–African American Patients with NDMM: Connect MM Registry

Conference Correspondent - ASCO 2017

A common cytogenetic abnormality, t(11;14), is typically associated with standard-risk and generally favorable multiple myeloma (MM) outcomes, but has demonstrated poor prognosis in patients in some recent retrospective analyses. A prospective, observational, multicenter registry, Connect MM collects data on the management and natural history of patients with newly diagnosed multiple myeloma (NDMM) in clinical practice. Researchers examined the impact of the mutation t(11;14) on survival outcomes in African American and non–African American patients.

For study inclusion, adult patients with NDMM who completed induction therapy were tested for t(11;14) mutation by fluorescence in situ hybridization/cytogenetics and were grouped by race: African American and non–African American. The primary end points tested in the study were progression-free survival (PFS) and overall survival (OS). The researchers conducted Kaplan-Meier analyses to adjust for differences in cohort, age, International Staging System stage, transplant intent, t(4;14) status, hemoglobin, platelets, calcium, creatinine, and diabetes history.

A total of 3011 patients were enrolled in the 2 cohorts (cohort 1: n = 1493, median follow-up, 39.3 months; cohort 2: n = 1518, median follow-up, 16.4 months). Of the 52% (n = 1539) of patients who were tested for t(11;14), 24% (n = 363) were t(11;14) positive, including 26% (53/205) of the African American patient population and 23% (310/1334) of the non–African American patient population. A nonsignificant trend of shorter PFS was observed in African American patients with t(11;14) mutation versus African American patients without t(11;14). African American patients with t(11;14) had a significantly higher risk of death versus those without t(11;14), and a higher rate of early mortality compared with non–African American patients. No differences in PFS or OS were noted in non–African American patients with or without t(11;14). For OS, the interaction between race and t(11;14) status was statistically significant; African American patients with t(11;14) reported poorer survival outcomes versus non–African American patients (P = 0.004).

Data from the Connect MM Registry indicated that the effect of t(11;14) on OS was significantly different between African American and non–African American patients. The presence of the (11;14) mutation in African Americans was associated with poorer survival outcomes and may be a risk factor for poor prognosis. Additional analyses will be conducted to better understand the impact of the t(11;14) mutation on treatment regimens in African American and non–African American patients.

Gasparetto C, et al. ASCO Abstract 8023.