Lenalidomide versus bortezomib maintenance after frontline autologous stem cell transplantation for multiple myeloma

German-speaking Myeloma Multicenter Group (GMMG)

Onderzoeksoutput: Articlepeer review

8 Citaten (Scopus)

Samenvatting

Lenalidomide (LEN) maintenance (MT) post autologous stem cell transplantation (ASCT) is standard of care in newly diagnosed multiple myeloma (MM) but has not been compared to other agents in clinical trials. We retrospectively compared bortezomib (BTZ; n = 138) or LEN (n = 183) MT from two subsequent GMMG phase III trials. All patients received three cycles of BTZ-based triplet induction and post-ASCT MT. BTZ MT (1.3 mg/m2 i.v.) was administered every 2 weeks for 2 years. LEN MT included two consolidation cycles (25 mg p.o., days 1-21 of 28 day cycles) followed by 10-15 mg/day for 2 years. The BTZ cohort more frequently received tandem ASCT (91% vs. 33%) due to different tandem ASCT strategies. In the LEN and BTZ cohort, 43% and 46% of patients completed 2 years of MT as intended (p = 0.57). Progression-free survival (PFS; HR = 0.83, p = 0.18) and overall survival (OS; HR = 0.70, p = 0.15) did not differ significantly with LEN vs. BTZ MT. Patients with <nCR after first ASCT were assigned tandem ASCT in both trials. In patients with <nCR and tandem ASCT (LEN: n = 54 vs. BTZ: n = 84), LEN MT significantly improved PFS (HR = 0.61, p = 0.04) but not OS (HR = 0.46, p = 0.09). In conclusion, the significant PFS benefit after eliminating the impact of different tandem ASCT rates supports the current standard of LEN MT after ASCT.

Originele taal-2English
Artikelnummer1
Aantal pagina's10
TijdschriftBlood Cancer Journal
Volume11
Nummer van het tijdschrift1
DOI's
StatusPublished - 7 jan 2021

Bibliografische nota

Funding Information:
We thank the investigators, the study nurses and all the members of the study teams at the participating GMMG trial sites, the teams of the myeloma research laboratory, the FISH laboratory and the central laboratory at the University Hospital Heidelberg, the coordination centers for clinical trials (KKS) in Heidelberg, Köln, Dresden and Leipzig, the pharmacies at the trial sites and, most importantly, the participating patients and their families. The GMMG-MM5 trial was supported by grants from Celgene, Janssen-Cilag, Chugai and Binding Site. The HOVON-65/GMMG-HD4 trial was supported by the Dutch Cancer Foundation, by the German Federal Ministry of Education and Research, and by a grant from Janssen Cilag. The GMMG also received grants for this trial by Novartis, Amgen, Chugai, Roche, and the Tumorzentrum Heidelberg/Mannheim.

Publisher Copyright:
© 2021, The Author(s).

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

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