Bortezomib-based induction, high-dose melphalan and lenalidomide maintenance in myeloma up to 70 years of age

German-speaking Myeloma Multicenter Group (GMMG)

Onderzoeksoutput: Articlepeer review

7 Citaten (Scopus)

Samenvatting

Intensive upfront therapy in newly-diagnosed multiple myeloma (MM) including induction therapy (IT), high-dose melphalan (MEL200), and autologous blood stem cell transplantation (ASCT) followed by consolidation and/or maintenance is mostly restricted to patients up to 65 years of age. Prospective phase III trial data in the era of novel agents for patients up to 70 years of age are not available. The GMMG-MM5 trial included 601 patients between 18 and 70 years of age, divided in three groups for the present analysis: ≤60 years (S1, n = 353), 61-65 years (S2, n = 107) and 66-70 years (S3, n = 141). Treatment consisted of a bortezomib-containing IT, MEL200/ASCT, consolidation, and maintenance with lenalidomide. Adherence to treatment was similar among patients of the three age groups. Overall toxicity during all treatment phases was increased in S2 and S3 compared to S1 (any adverse event/any serious adverse event: S1:81.7/41.8% vs. S2:90.7/56.5% vs. S3:87.2/68.1%, p = 0.05/<0.001). With respect to progression-free survival (log-rank p = 0.73), overall survival (log-rank p = 0.54) as well as time-to-progression (Gray's p = 0.83) and non-relapse mortality (Gray's p = 0.25), no differences were found between the three age groups. Our results imply that an intensive upfront therapy with a bortezomib-containing IT, MEL200/ASCT, lenalidomide consolidation, and maintenance should be applied to transplant-eligible MM patients up to 70 years of age.

Originele taal-2English
Pagina's (van-tot)809-822
Aantal pagina's14
TijdschriftLeukemia
Volume35
Nummer van het tijdschrift3
DOI's
StatusPublished - mrt 2021

Bibliografische nota

Funding Information:
Acknowledgements The GMMG-MM5 trial was supported by Cel-gene, Janssen-Cilag, Chugai and The Binding Site. The GMMG thanks the Koordinierungszentrum für Klinische Studien (KKS) Heidelberg for the support of the trial and data monitoring. The GMMG thanks all investigators, study centers (Supplementary Material 2) and participating patients.

Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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