ASCO20: Long-Term Outcomes With AutoHCT in Multiple Myeloma
Posted: Thursday, June 11, 2020
Tandem autologous hematopoietic cell transplantation (autoHCT) may convey a progression-free survival benefit for patients with multiple myeloma, according to 6-year follow-up results of the phase III clinical trial STaMINA. Parameswaran Hari, MD, of the Medical College of Wisconsin, Milwaukee, and colleagues presented their findings during the ASCO20 Virtual Scientific Program (Abstract 8506).
“Long-term outcomes are similar using intent-to-treat, but as-treated analysis suggested a progression-free survival benefit for tandem autoHCT, driven mainly by patients with high-risk multiple myeloma,” wrote the authors.
In this study, 758 patients were randomly assigned to one of three treatment groups: 1) tandem autoHCT followed by lenalidomide maintenance (247 patients); 2) single transplantation, consolidation with lenalidomide/bortezomib/dexamethasone, then lenalidomide maintenance (254 patients); 3) single transplantation, then lenalidomide maintenance (257 patients). STaMINA was designed to be 3 years long. The authors offered further follow-up on 431 eligible patients who were progression-free at 38 months: 179 chose to continue maintenance until disease progression.
In an intent-to-treat analysis, 6-year progression-free survival and overall survival rates were the same among the three treatments. However, in an as-treated analysis, 6-year progression-free survival was significantly higher with tandem transplantation (49.4%) than with group 2 (39.7%) or 3 (38.6%) treatment regimens. In high-risk patients, 6-year progression-free survival was also higher for the tandem transplantation group.
Lenalidomide discontinuation after 38 months was associated with lower progression-free survival. At 5 years, progression-free survival was 61% for patients who had discontinued lenalidomide and 79.5% for those who continued it (hazard ratio = 1.91). However, overall survival was similar.
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.