FIRST Trial: Survival Outcomes in Transplant-Ineligible Multiple Myeloma
In patients with transplant-ineligible newly diagnosed multiple myeloma, treatment with lenalidomide and low-dose dexamethasone until disease progression (Rd continuous) significantly improved progression-free and overall survival when compared with treatment with melphalan, prednisone, and thalidomide (MPT), according to data from the FIRST trial. Thierry Facon, MD, of the Hopital Claude Huriez, Lille, France, and colleagues published their final analysis of survival outcomes from this randomized phase III trial in Blood.
In the trial, 1,623 patients were assigned to Rd continuous (n = 535), Rd for 72 weeks/18 cycles (Rd18; n = 541), or MPT for 72 weeks (n = 547). After a median follow-up of more than 5 years, median progression-free survival was significantly longer with Rd continuous (26 months vs. 21 months for Rd18 and 21.9 months for MPT).
Median overall survival was also 10 months longer with Rd continuous versus MPT (59.1 vs. 49.1 months) but was similarly improved with Rd18 (62.3 months). “The benefit of overall survival observed with Rd continuous and Rd18 may be driven in part by optimized rescue therapy possibilities in patients treated with Rd versus those treated with MPT,” the researchers noted.
Furthermore, patients who achieved complete or very good partial responses with Rd continuous had a median time to next treatment that was about 30 months longer than that of patients who received Rd18 (69.5 vs. 39.9 months).