SOHO 2021: Does Prolonged Lenalidomide Maintenance Improve Survival After Transplant in Myeloma?
Posted: Wednesday, September 22, 2021
A longer duration of maintenance therapy with lenalidomide may improve overall survival compared with a shorter duration of treatment in patients with multiple myeloma after an autologous stem cell transplant (ASCT), according to the results of a retrospective study presented during the 2021 Society of Hematologic Oncology (SOHO) Annual Meeting (Abstract MM-429). This finding was irrespective of cytogenetic risk group and International Staging System (ISS) stage, reported Saurabh Zanwar, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues.
This study focused on 213 patients with multiple myeloma treated with lenalidomide-based maintenance therapy after ASCT at the Mayo Clinic between 2005 and 2016. The median follow-up was 5.4 years from diagnosis; of the 202 patients for whom cytogenetics data were available, 31% harbored high-risk cytogenetics.
The median progression-free survival was 4 years from diagnosis of multiple myeloma and 3 years from the start of lenalidomide maintenance. Excluding patients who experienced disease progression within 3 years of starting maintenance (n = 65), patients receiving at least 3 years of maintenance therapy (n = 48) had a superior 5-year overall survival of 100% compared with 88% of patients who received less than 3 years of maintenance therapy (n = 100; P = .011). Median progression-free survival was 7.2 years versus 4.4 years in the longer maintenance group compared with the shorter maintenance group; 5-year progression-free survival was 86% versus 35%, respectively (P < .0001). A longer duration of maintenance therapy also seemed to be associated with improved overall survival and progression-free survival after adjusting for age, ISS stage 3, cytogenetic risk, and maintenance regimen compared with those treated for less than 3 years.
As for safety, 16% of patients needed to discontinue therapy due to toxicity, and 4% developed a secondary malignancy.
Disclosure: No disclosure information was provided.
