AUTHOR=Ceglédi Andrea , Csukly Zoltán , Fekete Mónika , Kozma András , Szemlaky Zsuzsanna , Andrikovics Hajnalka , Mikala Gábor 

TITLE=Effective venetoclax-based treatment in relapsed/refractory multiple myeloma patients with translocation t(6;14)

JOURNAL=Pathology and Oncology Research

VOLUME=29

YEAR=2023

URL=https://www.por-journal.com/journals/pathology-and-oncology-research/articles/10.3389/pore.2023.1611375

DOI=10.3389/pore.2023.1611375

ISSN=1532-2807

ABSTRACT=<p><bold>Introduction<italic>:</italic></bold> The selective Bcl-2 inhibitor venetoclax has shown promising therapeutic potential in multiple myeloma, particularly in cases associated with t(11;14) <italic>IGH::CCND1</italic> translocation. However, the efficacy of venetoclax in myeloma patients with the t(6;14) <italic>IGH::CCND3</italic> translocation remains less investigated.</p><p><bold>Methods:</bold> In this study, we conducted a retrospective analysis to investigate the efficacy of venetoclax-based therapy in relapsed/refractory myeloma patients with t(6;14) translocation. The treatment courses of three patients, that included previous therapies and responses to venetoclax, were assessed. Clinical data, laboratory results, and adverse events were analyzed to evaluate treatment outcomes.</p><p><bold>Results:</bold> Our findings demonstrated remarkable therapeutic responses in three consecutive patients with t(6;14) translocation-associated myeloma who received venetoclax-based therapy. Patient 1, a lenalidomide-bortezomib-daratumumab and alkylator treatment refractory patient, achieved sustained stringent complete remission (sCR) after combining carfilzomib-dexamethasone with venetoclax, which was his best response ever. Similarly, Patient 2, refractory to frontline bortezomib-thalidomide-dexamethasone therapy, attained CR following a transition to bortezomib-dexamethason-venetoclax treatment. Patient 3, who was immunomodulatory (IMID)-intolerant, showed a highly favorable response to venetoclax-dexamethasone therapy after his first relapse following autologous stem cell transplantation. No significant adverse effects were observed in any of the patients.</p><p><bold>Discussion:</bold> Our study provides compelling preliminary evidence for the efficacy of venetoclax in t(6;14) translocation-associated myeloma. The outcomes observed in our patients suggest that venetoclax-based therapy holds substantial promise as an effective treatment option for this specific genetic subgroup. Furthermore, the similarities in treatment response between t(11;14) and t(6;14) translocation subgroups highlight the importance of personalized approaches targeting specific genetic abnormalities to optimize therapeutic outcomes.</p>