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Refractory Malignant Neoplasm of Multiple Primary Sites

MedGen UID:
1661967
•Concept ID:
C4725805
•
Neoplastic Process

Definition

Malignant neoplasm of multiple primary sites that is resistant to treatment. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRefractory Malignant Neoplasm of Multiple Primary Sites

Professional guidelines

PubMed

Brain Metastases in Differentiated Thyroid Cancer: Clinical Presentation, Diagnosis, and Management.
Prinzi A, van Velsen EFS, Belfiore A, Frasca F, Malandrino P
Thyroid 2024 Oct;34(10):1194-1204. Epub 2024 Sep 4 doi: 10.1089/thy.2024.0240. PMID: 39163020
Pathobiology and treatment of lymphomatoid granulomatosis, a rare EBV-driven disorder.
Melani C, Jaffe ES, Wilson WH
Blood 2020 Apr 16;135(16):1344-1352. doi: 10.1182/blood.2019000933. PMID: 32107539Free PMC Article
Treatment of primary mediastinal B-cell lymphoma with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone is associated with a high rate of primary refractory disease.
Soumerai JD, Hellmann MD, Feng Y, Sohani AR, Toomey CE, Barnes JA, Takvorian RW, Neuberg D, Hochberg EP, Abramson JS
Leuk Lymphoma 2014 Mar;55(3):538-43. Epub 2013 Jul 29 doi: 10.3109/10428194.2013.810738. PMID: 23734654

Recent clinical studies

Etiology

Efficacy and safety of single-agent belantamab mafodotin versus pomalidomide plus low-dose dexamethasone in patients with relapsed or refractory multiple myeloma (DREAMM-3): a phase 3, open-label, randomised study.
Dimopoulos MA, Hungria VTM, Radinoff A, Delimpasi S, Mikala G, Masszi T, Li J, Capra M, Maiolino A, Pappa V, Chraniuk D, Osipov I, Leleu X, Low M, Matsumoto M, Sule N, Li M, McKeown A, He W, Bright S, Currie B, Perera S, Boyle J, Roy-Ghanta S, Opalinska J, Weisel K
Lancet Haematol 2023 Oct;10(10):e801-e812. doi: 10.1016/S2352-3026(23)00243-0. PMID: 37793771
Phase II, Open-Label Study of Ciltacabtagene Autoleucel, an Anti-B-Cell Maturation Antigen Chimeric Antigen Receptor-T-Cell Therapy, in Chinese Patients With Relapsed/Refractory Multiple Myeloma (CARTIFAN-1).
Mi JQ, Zhao W, Jing H, Fu W, Hu J, Chen L, Zhang Y, Yao D, Chen D, Schecter JM, Yang F, Tian X, Sun H, Zhuang SH, Ren J, Fan X, Jin J, Niu T, Chen SJ
J Clin Oncol 2023 Feb 20;41(6):1275-1284. Epub 2022 Oct 21 doi: 10.1200/JCO.22.00690. PMID: 36269898
Four-year follow-up of LCAR-B38M in relapsed or refractory multiple myeloma: a phase 1, single-arm, open-label, multicenter study in China (LEGEND-2).
Zhao WH, Wang BY, Chen LJ, Fu WJ, Xu J, Liu J, Jin SW, Chen YX, Cao XM, Yang Y, Zhang YL, Wang FX, Zhang PY, Lei B, Gu LF, Wang JL, Zhang H, Bai J, Xu Y, Zhu H, Du J, Jiang H, Fan XH, Li JY, Hou J, Chen Z, Zhang WG, Mi JQ, Chen SJ, He AL
J Hematol Oncol 2022 Jul 6;15(1):86. doi: 10.1186/s13045-022-01301-8. PMID: 35794616Free PMC Article
Carfilzomib, dexamethasone, and daratumumab versus carfilzomib and dexamethasone for patients with relapsed or refractory multiple myeloma (CANDOR): results from a randomised, multicentre, open-label, phase 3 study.
Dimopoulos M, Quach H, Mateos MV, Landgren O, Leleu X, Siegel D, Weisel K, Yang H, Klippel Z, Zahlten-Kumeli A, Usmani SZ
Lancet 2020 Jul 18;396(10245):186-197. doi: 10.1016/S0140-6736(20)30734-0. PMID: 32682484
Once weekly versus twice weekly carfilzomib dosing in patients with relapsed and refractory multiple myeloma (A.R.R.O.W.): interim analysis results of a randomised, phase 3 study.
Moreau P, Mateos MV, Berenson JR, Weisel K, Lazzaro A, Song K, Dimopoulos MA, Huang M, Zahlten-Kumeli A, Stewart AK
Lancet Oncol 2018 Jul;19(7):953-964. Epub 2018 Jun 1 doi: 10.1016/S1470-2045(18)30354-1. PMID: 29866475

Diagnosis

Brain Metastases in Differentiated Thyroid Cancer: Clinical Presentation, Diagnosis, and Management.
Prinzi A, van Velsen EFS, Belfiore A, Frasca F, Malandrino P
Thyroid 2024 Oct;34(10):1194-1204. Epub 2024 Sep 4 doi: 10.1089/thy.2024.0240. PMID: 39163020
Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6): results from a randomised, phase 3 trial.
Mai EK, Goldschmid H, Miah K, Bertsch U, Besemer B, Hänel M, Krzykalla J, Fenk R, Schlenzka J, Munder M, Dürig J, Blau IW, Huhn S, Hose D, Jauch A, Kunz C, Mann C, Weinhold N, Scheid C, Schroers R, von Metzler I, Schieferdecker A, Thomalla J, Reimer P, Mahlberg R, Graeven U, Kremers S, Martens UM, Kunz C, Hensel M, Benner A, Seidel-Glätzer A, Weisel KC, Raab MS, Salwender HJ; German-speaking Myeloma Multicenter Group (GMMG) HD6 investigators
Lancet Haematol 2024 Feb;11(2):e101-e113. doi: 10.1016/S2352-3026(23)00366-6. PMID: 38302221
Anti-PD-1 immunotherapy with androgen deprivation therapy induces robust immune infiltration in metastatic castration-sensitive prostate cancer.
Hawley JE, Obradovic AZ, Dallos MC, Lim EA, Runcie K, Ager CR, McKiernan J, Anderson CB, Decastro GJ, Weintraub J, Virk R, Lowy I, Hu J, Chaimowitz MG, Guo XV, Zhang Y, Haffner MC, Worley J, Stein MN, Califano A, Drake CG
Cancer Cell 2023 Nov 13;41(11):1972-1988.e5. Epub 2023 Nov 2 doi: 10.1016/j.ccell.2023.10.006. PMID: 37922910Free PMC Article
Selinexor plus low-dose dexamethasone in Chinese patients with relapsed/refractory multiple myeloma previously treated with an immunomodulatory agent and a proteasome inhibitor (MARCH): a phase II, single-arm study.
Qiu L, Xia Z, Fu C, Chen W, Chang C, Fang B, An G, Wei Y, Cai Z, Gao S, Weng J, Chen L, Jing H, Li F, Liu Z, Chen X, Liu J, Wang A, Yu Y, Xiang W, Lynch K, Yu Z, Fu W
BMC Med 2022 Apr 5;20(1):108. doi: 10.1186/s12916-022-02305-4. PMID: 35379237Free PMC Article
Pathobiology and treatment of lymphomatoid granulomatosis, a rare EBV-driven disorder.
Melani C, Jaffe ES, Wilson WH
Blood 2020 Apr 16;135(16):1344-1352. doi: 10.1182/blood.2019000933. PMID: 32107539Free PMC Article

Therapy

Anti-PD-1 immunotherapy with androgen deprivation therapy induces robust immune infiltration in metastatic castration-sensitive prostate cancer.
Hawley JE, Obradovic AZ, Dallos MC, Lim EA, Runcie K, Ager CR, McKiernan J, Anderson CB, Decastro GJ, Weintraub J, Virk R, Lowy I, Hu J, Chaimowitz MG, Guo XV, Zhang Y, Haffner MC, Worley J, Stein MN, Califano A, Drake CG
Cancer Cell 2023 Nov 13;41(11):1972-1988.e5. Epub 2023 Nov 2 doi: 10.1016/j.ccell.2023.10.006. PMID: 37922910Free PMC Article
Efficacy and safety of single-agent belantamab mafodotin versus pomalidomide plus low-dose dexamethasone in patients with relapsed or refractory multiple myeloma (DREAMM-3): a phase 3, open-label, randomised study.
Dimopoulos MA, Hungria VTM, Radinoff A, Delimpasi S, Mikala G, Masszi T, Li J, Capra M, Maiolino A, Pappa V, Chraniuk D, Osipov I, Leleu X, Low M, Matsumoto M, Sule N, Li M, McKeown A, He W, Bright S, Currie B, Perera S, Boyle J, Roy-Ghanta S, Opalinska J, Weisel K
Lancet Haematol 2023 Oct;10(10):e801-e812. doi: 10.1016/S2352-3026(23)00243-0. PMID: 37793771
Phase II, Open-Label Study of Ciltacabtagene Autoleucel, an Anti-B-Cell Maturation Antigen Chimeric Antigen Receptor-T-Cell Therapy, in Chinese Patients With Relapsed/Refractory Multiple Myeloma (CARTIFAN-1).
Mi JQ, Zhao W, Jing H, Fu W, Hu J, Chen L, Zhang Y, Yao D, Chen D, Schecter JM, Yang F, Tian X, Sun H, Zhuang SH, Ren J, Fan X, Jin J, Niu T, Chen SJ
J Clin Oncol 2023 Feb 20;41(6):1275-1284. Epub 2022 Oct 21 doi: 10.1200/JCO.22.00690. PMID: 36269898
A phase II basket trial of Dual Anti-CTLA-4 and Anti-PD-1 Blockade in Rare Tumors (DART) SWOG S1609: High-grade neuroendocrine neoplasm cohort.
Patel SP, Mayerson E, Chae YK, Strosberg J, Wang J, Konda B, Hayward J, McLeod CM, Chen HX, Sharon E, Othus M, Ryan CW, Plets M, Blanke CD, Kurzrock R
Cancer 2021 Sep 1;127(17):3194-3201. Epub 2021 Apr 21 doi: 10.1002/cncr.33591. PMID: 33882143Free PMC Article
Carfilzomib, dexamethasone, and daratumumab versus carfilzomib and dexamethasone for patients with relapsed or refractory multiple myeloma (CANDOR): results from a randomised, multicentre, open-label, phase 3 study.
Dimopoulos M, Quach H, Mateos MV, Landgren O, Leleu X, Siegel D, Weisel K, Yang H, Klippel Z, Zahlten-Kumeli A, Usmani SZ
Lancet 2020 Jul 18;396(10245):186-197. doi: 10.1016/S0140-6736(20)30734-0. PMID: 32682484

Prognosis

Brain Metastases in Differentiated Thyroid Cancer: Clinical Presentation, Diagnosis, and Management.
Prinzi A, van Velsen EFS, Belfiore A, Frasca F, Malandrino P
Thyroid 2024 Oct;34(10):1194-1204. Epub 2024 Sep 4 doi: 10.1089/thy.2024.0240. PMID: 39163020
Four-year follow-up of LCAR-B38M in relapsed or refractory multiple myeloma: a phase 1, single-arm, open-label, multicenter study in China (LEGEND-2).
Zhao WH, Wang BY, Chen LJ, Fu WJ, Xu J, Liu J, Jin SW, Chen YX, Cao XM, Yang Y, Zhang YL, Wang FX, Zhang PY, Lei B, Gu LF, Wang JL, Zhang H, Bai J, Xu Y, Zhu H, Du J, Jiang H, Fan XH, Li JY, Hou J, Chen Z, Zhang WG, Mi JQ, Chen SJ, He AL
J Hematol Oncol 2022 Jul 6;15(1):86. doi: 10.1186/s13045-022-01301-8. PMID: 35794616Free PMC Article
Orbital metastasis from thyroid cancer: a case report and review of the literature.
Sapuppo G, Martorana F, Tirrò E, Le Moli R, Masucci R, Baldeschi L, Spatola C, Belfiore A, Vigneri P, Pellegriti G
Ann Palliat Med 2022 Oct;11(10):3346-3355. Epub 2022 Jun 2 doi: 10.21037/apm-22-61. PMID: 35695049
Patterns of Failure and Survival Outcomes after Total Lymphoid Irradiation and High-Dose Chemotherapy with Autologous Stem Cell Transplantation for Relapsed or Refractory Classical Hodgkin Lymphoma.
Paudel N, Schulze D, Gentzler RD, Evens AM, Helenowski I, Dillehay G, Frankfurt O, Mehta J, Donnelly ED, Gordon LI, Winter JN, Mittal BB
Int J Radiat Oncol Biol Phys 2019 Jun 1;104(2):436-446. Epub 2019 Feb 11 doi: 10.1016/j.ijrobp.2019.02.007. PMID: 30763660
Once weekly versus twice weekly carfilzomib dosing in patients with relapsed and refractory multiple myeloma (A.R.R.O.W.): interim analysis results of a randomised, phase 3 study.
Moreau P, Mateos MV, Berenson JR, Weisel K, Lazzaro A, Song K, Dimopoulos MA, Huang M, Zahlten-Kumeli A, Stewart AK
Lancet Oncol 2018 Jul;19(7):953-964. Epub 2018 Jun 1 doi: 10.1016/S1470-2045(18)30354-1. PMID: 29866475

Clinical prediction guides

Pembrolizumab and low-dose, single-fraction radiotherapy for patients with relapsed or refractory multiple myeloma: a prospective, single-centre, single-group, open-label, phase 2 pilot trial in the USA.
Khan MK, Nasti TH, Qian JY, Kleber TJ, Switchenko JM, Kaufman JL, Nooka AJ, Dhodapkar MV, Buchwald ZS, Obiekwe D, Lonial S, Ahmed R
Lancet Haematol 2024 Jul;11(7):e510-e520. Epub 2024 May 23 doi: 10.1016/S2352-3026(24)00105-4. PMID: 38797190
Elotuzumab, lenalidomide, bortezomib, dexamethasone, and autologous haematopoietic stem-cell transplantation for newly diagnosed multiple myeloma (GMMG-HD6): results from a randomised, phase 3 trial.
Mai EK, Goldschmid H, Miah K, Bertsch U, Besemer B, Hänel M, Krzykalla J, Fenk R, Schlenzka J, Munder M, Dürig J, Blau IW, Huhn S, Hose D, Jauch A, Kunz C, Mann C, Weinhold N, Scheid C, Schroers R, von Metzler I, Schieferdecker A, Thomalla J, Reimer P, Mahlberg R, Graeven U, Kremers S, Martens UM, Kunz C, Hensel M, Benner A, Seidel-Glätzer A, Weisel KC, Raab MS, Salwender HJ; German-speaking Myeloma Multicenter Group (GMMG) HD6 investigators
Lancet Haematol 2024 Feb;11(2):e101-e113. doi: 10.1016/S2352-3026(23)00366-6. PMID: 38302221
Anti-PD-1 immunotherapy with androgen deprivation therapy induces robust immune infiltration in metastatic castration-sensitive prostate cancer.
Hawley JE, Obradovic AZ, Dallos MC, Lim EA, Runcie K, Ager CR, McKiernan J, Anderson CB, Decastro GJ, Weintraub J, Virk R, Lowy I, Hu J, Chaimowitz MG, Guo XV, Zhang Y, Haffner MC, Worley J, Stein MN, Califano A, Drake CG
Cancer Cell 2023 Nov 13;41(11):1972-1988.e5. Epub 2023 Nov 2 doi: 10.1016/j.ccell.2023.10.006. PMID: 37922910Free PMC Article
Four-year follow-up of LCAR-B38M in relapsed or refractory multiple myeloma: a phase 1, single-arm, open-label, multicenter study in China (LEGEND-2).
Zhao WH, Wang BY, Chen LJ, Fu WJ, Xu J, Liu J, Jin SW, Chen YX, Cao XM, Yang Y, Zhang YL, Wang FX, Zhang PY, Lei B, Gu LF, Wang JL, Zhang H, Bai J, Xu Y, Zhu H, Du J, Jiang H, Fan XH, Li JY, Hou J, Chen Z, Zhang WG, Mi JQ, Chen SJ, He AL
J Hematol Oncol 2022 Jul 6;15(1):86. doi: 10.1186/s13045-022-01301-8. PMID: 35794616Free PMC Article
Subcutaneous versus intravenous daratumumab in patients with relapsed or refractory multiple myeloma (COLUMBA): a multicentre, open-label, non-inferiority, randomised, phase 3 trial.
Mateos MV, Nahi H, Legiec W, Grosicki S, Vorobyev V, Spicka I, Hungria V, Korenkova S, Bahlis N, Flogegard M, Bladé J, Moreau P, Kaiser M, Iida S, Laubach J, Magen H, Cavo M, Hulin C, White D, De Stefano V, Clemens PL, Masterson T, Lantz K, O'Rourke L, Heuck C, Qin X, Parasrampuria DA, Yuan Z, Xu S, Qi M, Usmani SZ
Lancet Haematol 2020 May;7(5):e370-e380. Epub 2020 Mar 23 doi: 10.1016/S2352-3026(20)30070-3. PMID: 32213342

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