Lenalidomide Maintenance After Transplantation in Multiple Myeloma
Lenalidomide maintenance after autologous stem cell transplantation (ASCT) in newly diagnosed patients with multiple myeloma seems to improve both progression-free and overall survival compared with placebo or observation, according to a met-analysis reported in the Journal of Clinical Oncology. These findings were reported by Philip L. McCarthy, MD, of Roswell Park Cancer Institute, Buffalo, New York, and colleagues.
Included in this meta-analysis were patient-level data from 1208 patients from 3 clinical trials: Cancer and Leukemia Group B 100104, Gruppo Italiano Malattie Ematologiche dell’Adulto RV-MM-PI-209, and Intergroupe Francophone du Myélome 2005-02. A total of 605 patients received lenalidomide maintenance, and 603 received either placebo or observation.
Median progression-free survival was longer with lenalidomide maintenance than without it (52.8 vs. 23.5 months; hazard ratio = 0.55). Median overall survival at a median follow-up of 79.5 months was not reached in the lenalidomide group compared with 86.0 months in the placebo/observation group (hazard ratio = 0.75).
In addition, the cumulative incidence rate of a second primary malignancy before disease progression was higher with lenalidomide than without it (5.3% vs. 0.8% for hematologic and 5.8% vs. 2.0% for solid tumors). On the other hand, the cumulative incidence rates of disease progression, death, or death as a results of myeloma were all higher with placebo/observation than with lenalidomide maintenance.