Multiple myeloma: real-world outcomes with frontline RVD induction and consolidation after ASCT

  • Arcani R & al.
  • Eur J Haematol
  • 18 Jul 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • In patients with multiple myeloma (MM), autologous stem cell transplantation (ASCT) following lenalidomide, bortezomib, and dexamethasone (RVD) induction as frontline therapy delivered outcomes consistent with those seen in clinical trials.
  • RVD was well-tolerated, supporting its applicability in patients ineligible for transplant.

Why this matters

  • This may be the first time real-world data have been published for this regimen.

Study design

  • Study to investigate ASCT following RVD induction as frontline therapy in 40 real-world patients with MM.
  • Treatment comprised RVD induction, conditioning with high-dose melphalan (HDM), RVD consolidation, and then lenalidomide maintenance.
  • Funding: None disclosed.

Key results

  • Responses by treatment phase:
    • After induction: stringent complete response (sCR): 0%; complete response (CR): 22.5%; very good partial response (VGPR): 52.5%; partial response (PR): 25%.
    • After ASCT: sCR: 2.5%; CR: 30%; VGPR: 62.5%; PR: 5%.
    • After consolidation: sCR: 22.5%; CR: 27.5%; VGPR: 42.5%; PR: 7.5%.
  • 45 months median PFS (range, 10-75 months); 76 months median OS (range, 14-86 months).
  • 22.5% of patients experienced a grade ≥3 adverse event at any time.
  • Minimal residual disease (MRD)-negativity was the only factor associated with significantly improved PFS (P=.008).

Limitations

  • Single-arm, retrospective study.