Multiple Myeloma Coverage From Every Angle
Advertisement
Advertisement

ASH 2018: Transplant Versus Continuous Lenalidomide-Based Therapy for Relapsed Multiple Myeloma

By: Sarah Campen, PharmD
Posted: Monday, December 3, 2018

In patients with relapsed multiple myeloma, salvage high-dose chemotherapy followed by autologous stem cell transplantation appears to have similar efficacy compared with continuous lenalidomide-based therapy, according to the results of a trial presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition in San Diego (Abstract 253). However, as Hartmut Goldschmidt, MD, of the University Hospital Heidelberg, Germany, and colleagues noted, almost 30% of patients in the transplant arm did not receive the planned treatment.

“The number of patients not undergoing salvage [high-dose chemotherapy/autologous stem cell transplantation] and the approval of more active [lenalidomide/dexamethasone]-based triplet regimens after the initiation of this trial prevents definite conclusions” on the role of salvage chemotherapy and transplant, explained the researchers. Exploratory landmark analyses revealed a trend toward superior progression-free survival (23.1 vs. 20.1 months) and significantly superior overall survival (not reached vs. 57 months) in the transplant versus maintenance arm; however, the response rate and progression-free survival based on the overall trial population did not significantly differ.

Treatment in the transplant arm (n = 139) included re-induction with 3 rounds of lenalidomide plus dexamethasone, high-dose melphalan, autologous stem cell transplantation, and lenalidomide maintenance until disease progression. Patients in the no-transplant arm (n = 138) received continuous lenalidomide and dexamethasone until disease progression. More than 90% of patients in both arms had 1 prior therapy line, and there was a significantly higher incidence of high-risk cytogenetic aberrations in the transplant arm (42.9% vs. 31.6%). As for safety, higher rates of leukopenia, neutropenia, grade ≥ 3 thrombocytopenia, and grade ≥ 3 mucositis were seen in the transplant arm.



By continuing to browse this site you permit us and our partners to place identification cookies on your browser and agree to our use of cookies to identify you for marketing. Read our Privacy Policy to learn more.