Abstract 846P
Background
Multiple myelomas (MM) is the second most common hematological malignancy. Accurate risk stratification of MM patients is important for prognosis and to define the best treatment strategy. Vascular endothelial growth factor (VEGF) is considered a key regulator in angiogenesis and an important driver of neovascularization. We studied the predictive and prognostic values of serum VEGF in patients with newly diagnosed MM receiving bortezomib, cyclophosphamide and dexamethasone.
Methods
This study included thirty-nine newly diagnosed MM patients presented to South Egypt Cancer Institute and Hematological Unit of Internal Medicine Department, Assiut University, from July 2017 to March 2021. All patients received bortezomib, cyclophosphamide and dexamethasone at least for 3 months. Measurement of serum VEGF was done by Magnetic Luminex® Assay multiplex kits. Normal range is 7.98-107.46 pg/ml.
Results
In total 39 patients, there were 29 males and 10 females with their mean age of 58.3 ± 8.8 years and range of 40–79 years. According to the R-ISS stages; 20.5% of patients had stage I, 43.5% of patients had stage II and 36% of patients had stage III. The Mean ± SEM of VEGF (pg/ml) was 112.09 ±13.25, with range of 4.08-419.50. Seventeen patients (43.6%) had increased level of serum VEGF. Patients with increased VEGF level had a ≥ VGPR (very good partial response) lesser than those patients with normal VEGF level (P= .047). Also, the increased VEGF level was associated with worse progression-free survival (PFS) and overall survival (OS). Patients with increased level of VEGF had mean PFS ± SEM (standard error of mean), 95% CI of 18.6 ± 2.4, 13.9 - 23.3 months vs 35.8 ± 3.6, 3.6-28.6 months for patients with normal VEGF level (P=.003). Like PFS, patients with increased level of VEGF had mean OS ± SEM, 95% CI of 29.1 ± 2.9, 23.3 – 35.01 months vs 42.9±1.3, 40.3-45.5 months for patients with normal VEGF level (P=.005).
Conclusions
In multiple myeloma patients, the high level of VEGF is a bad predictive and prognostic marker. It should be more investigated and it may be targeted in the near future.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
South Egypt Cancer Institute, Assiut University.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.