Bortezomib improves progression-free survival in multiple myeloma patients overexpressing preferentially expressed antigen of melanoma

作者：Qin Yazhen; Lu Jin; Bao Li; Zhu Honghu; Li Jinlan; Li Lingdi; Lai Yueyun; Shi Hongxia; Wang Yazhe; Liu Yanrong; Jiang Bin; Huang Xiaojun^*

来源：Chinese Medical Journal, 2014, 127(9): 1666-1671.

DOI：10.3760/cma.j.issn.0366-6999.20132356

• multiple myeloma
• preferentially expressed antigen of melanoma expression
• bortezomib
• progression-free survival
• real-time quantitative polymerase chain reaction

Background Significant efforts have been made to identify factors that differentiate patients treated with novel therapies, such as bortezomib in multiple myeloma (MM). The exact expression pattern and prognostic value of the cancer/testis antigen preferentially expressed antigen of melanoma (PRAME) in MM are unknown and were explored in this study.
Methods The transcript level of FRAME was detected in bone marrow specimens from 100 newly diagnosed MM patients using real-time quantitative polymerase chain reaction, and the prognostic value of FRAME was determined through retrospective survival analysis. FRAME expression higher than the upper limit of normal bone marrow was defined as PRAME overexpression or FRAME (+).
Results Sixty-two patients (62.0%) overexpressed FRAME. FRAME overexpression showed no prognostic significance to either overall survival (n=100) or progression-free survival (PFS, n=96, all P > 0.05) of patients. The patients were also categorized according to regimens with or without bortezomib. FRAME overexpression tended to be associated with a lower two-year PFS rate in patients treated with non-bortezomib-containing regimens (53.5% vs. 76.9%, P=0.071). By contrast, it was not associated with the two-year PFS rate in patients with bortezomib-containing regimens (77.5% vs. 63.9%, P > 0.05). When the patients were categorized into PRAME (+) and FRAME () groups, treatment with bortezomib-containing regimens predicted a higher two-year PFS rate in FRAME (+) patients (77.5% vs. 53.5%, P=0.027) but showed no significant effect on two-year PFS rate in FRAME () patients (63.9% vs. 76.9%, P > 0.05).
Conclusion FRAME overexpression might be an adverse prognostic factor of PFS in MM patients treated with non-bortezonnib-containing regimens. Bortezomib improves PFS in patients overexpressing PRAME.

• 出版日期2014-5-5
• 单位北京大学