Our preclinical studies confirmed that the combination of lenalidomide with Bortezomib targeting multiple myeloma (MM) cell in its microenvironment triggered dual apoptotic signaling. Our collaborators at the Dana Farber Cancer Institute (DFCI rapidly translated these data to a phase l/ll clinical trial of combination lenalidomide, Bortezomib and Dexamethasone (RVD) therapy in relapsed refractory MM which defined the MTD, favorable tolerability, and remarkable anti-MM activity. A phase l/ll trial of RVD in newly diagnosed MM patients showed 100% responses (^PR) even in high risk cytogenetic subgroups, including 48% CR/nCR and 74% SVGPR. These unprecedented rates and extent of response to initial therapy raise an important question regarding the role of high-dose therapy and stem cell transplantation (HDT) with RVD combination therapy. Our hypothesis is that the integration of HDT following induction with RVD combination therapy will improve outcome in MM. In this Project, we will randomize 1,000 patients to RVD versus RVD with HDT to determine whether addition of HDT improves time to progression, response, event free, and overall survival (Sp Aim la). We will determine whether known prognostic factors such as the International Staging System (a2 microglobulin and albumin), LDH, and FISH, as well as recently reported combination of ISS and FISH abnormalities, correlate with response and survival outcomes (Sp Aim lb).
In Specific Aim 2 we will evaluate whether further stringent CR definition predicts superior survival outcome. We will compare normalization of serum free light chain, immunophenotypic CR using multicolor flow cytometric immunophenotyping of MM cells in bone marrow, and molecular CR using ASO-PCR as measures to detect minimal residual disease to define stringent CR. This project will determine role of high-dose therapy In the era of novel agent therapy.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Program Projects (P01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1-RPRB-J)
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Dana-Farber Cancer Institute
United States
Zip Code
Singh, Irtisha; Lee, Shih-Han; Sperling, Adam S et al. (2018) Widespread intronic polyadenylation diversifies immune cell transcriptomes. Nat Commun 9:1716
Xu, Yan; Deng, Shuhui; Mao, Xuehan et al. (2018) Tolerance, Kinetics, and Depth of Response for Subcutaneous Versus Intravenous Administration of Bortezomib Combination in Chinese Patients With Newly Diagnosed Multiple Myeloma. Clin Lymphoma Myeloma Leuk 18:422-430
Bolli, Niccolo; Biancon, Giulia; Moarii, Matahi et al. (2018) Analysis of the genomic landscape of multiple myeloma highlights novel prognostic markers and disease subgroups. Leukemia 32:2604-2616
Botta, C; Cucè, M; Pitari, M R et al. (2018) MiR-29b antagonizes the pro-inflammatory tumor-promoting activity of multiple myeloma-educated dendritic cells. Leukemia 32:1003-1015
Zeid, Rhamy; Lawlor, Matthew A; Poon, Evon et al. (2018) Enhancer invasion shapes MYCN-dependent transcriptional amplification in neuroblastoma. Nat Genet 50:515-523
Maura, F; Petljak, M; Lionetti, M et al. (2018) Biological and prognostic impact of APOBEC-induced mutations in the spectrum of plasma cell dyscrasias and multiple myeloma cell lines. Leukemia 32:1044-1048
Bae, J; Hideshima, T; Zhang, G L et al. (2018) Identification and characterization of HLA-A24-specific XBP1, CD138 (Syndecan-1) and CS1 (SLAMF7) peptides inducing antigens-specific memory cytotoxic T lymphocytes targeting multiple myeloma. Leukemia 32:752-764
O'Donnell, Elizabeth K; Laubach, Jacob P; Yee, Andrew J et al. (2018) A phase 2 study of modified lenalidomide, bortezomib and dexamethasone in transplant-ineligible multiple myeloma. Br J Haematol 182:222-230
Guo, Guangwu; Raje, Noopur S; Seifer, Charles et al. (2018) Genomic discovery and clonal tracking in multiple myeloma by cell-free DNA sequencing. Leukemia 32:1838-1841
Szalat, R; Samur, M K; Fulciniti, M et al. (2018) Nucleotide excision repair is a potential therapeutic target in multiple myeloma. Leukemia 32:111-119

Showing the most recent 10 out of 218 publications