Triplet Regimen and Transplantation in Recently Diagnosed Multiple Myeloma
Posted: Monday, October 12, 2020
Incorporating autologous stem cell transplantation into a triplet combination of carfilzomib, lenalidomide, and dexamethasone (KRd) showed activity in patients with newly diagnosed multiple myeloma who were transplant-ineligible or -eligible but deferred transplantation. A recent study conducted by Andrzej J. Jakubowiak, MD, PhD, of the University of Chicago, and colleagues found that patients with newly diagnosed multiple myeloma achieved high stringent complete response rates and minimal residual disease negativity at the end of KRd consolidation. Their results were published in the journal Blood.
This phase II multicenter study included 76 patients, with a median age of 59 years. All patients received 4 cycles of KRd induction followed by transplantation, 4 cycles of KRd consolidation, and finally 10 cycles of KRd maintenance. Each cycle was 28 days in length. To compare the effect of incorporating autologous stem cell transplantation, the researchers used a design and dosing approach similar to a prior KRd study without autologous stem cell transplantation.
In total, 64 of 76 patients completed 18 cycles of KRd; 12 patients discontinued treatment early, and 72 underwent transplantation. After a median follow-up of 56 months, median progression-free and overall survival times were not reached. The estimated 5-year progression-free response and overall survival rates were 72% and 84%, respectively. Progression-free survival and overall survival in patients with no minimal residual disease (n = 39) were estimated to be at 85% and 91%.
“Our results support strategies to further enhance very active regimens with an objective to improve stringent complete response and minimal residual disease–negative rates, particularly for patients with high-risk disease,” noted the researchers.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.