EBMT 2018: Induction Therapy Prior to Surgery in Patients With Multiple Myeloma
Posted: Thursday, April 5, 2018
Patients younger than age 65 with newly diagnosed symptomatic multiple myeloma may benefit from induction therapy of bortezomib, lenalidomide, and dexamethasone (VRD-GEM) prior to autologous stem cell transplantation, according to research led by Laura Rosiñol, MD, PhD, of the Hospital Clinic de Barcelona. Results from the phase III, randomized PETHEMA/GEM trial were presented at the 2018 European Society for Blood and Marrow Transplantation (EBMT) Annual Meeting in Lisbon (Abstract SS6-2).
“Stem cell mobilization after three cycles of VRD-GEM is highly effective. Responses continue to deepen throughout treatment, with 58% of patients achieving [minimal residual disease] negativity post-consolidation,” the authors wrote.
The researchers evaluated complete response rates and minimal residual disease after each treatment step in 458 patients with multiple myeloma. After induction therapy, the overall response rate was 85%, and the complete response and very good partial response rates were 39% and 29%, respectively. After autologous stem cell transplantation, the overall response rate was 83%, including a 49% complete response rate and a 27% very good partial response rate. The complete response rate increased further to 58% after consolidation therapy.
Minimal residual disease was measured in 320 patients for whom the data were available. The percentage of patients without minimal residual disease increased from 34.5% to 53.5% and then 58% after induction, transplantation, and consolidation, respectively. As for toxicity, grade 3/4 neutropenia was reported in 11% of patients and thrombocytopenia, in 6%. Dose reductions due to side effects were needed in about one-third of patients.
