- Bortezomib+lenalidomide+dexamethasone (VRD) proved effective for pre-autologous stem cell transplant (ASCT) induction in patients newly diagnosed with multiple myeloma.
Why this matters
- Authors say VRD induction can be considered “a new standard of care” based on these phase 3 trial results.
- 81.0% completed all phases of treatment.
- Among 426 patients who initiated cycle 6, ≥very good partial response rates increased over time:
- 55.6% by cycle 3;
- 63.8% by cycle 4;
- 68.3% by cycle 5; and
- 70.4% after induction.
- After induction, the intent-to-treat complete response (CR) rate was 33.4%, and was similar (34.8%) among patients with high-risk cytogenetics; 6.8% had progression.
- The intent-to-treat CR rate increased to 44.1% after ASCT and 50.2% after VRD consolidation therapy.
- Rates of undetectable minimal residual disease (MRD):
- 28.8% at induction;
- 42.1% at transplant; and
- 45.2% at consolidation.
- Most common treatment-emergent adverse events: neutropenia (12.9%) and infection (9.2%).
- Grade 2+ peripheral neuropathy rate was 17.0%.
- 13.3% discontinued (34/61 progressive disease; 10/61 toxicity; 5/61 died).
- Multicenter PETHEMA/GEM2012 Spanish study of 458 patients aged ≤65 (median, 58) years with newly diagnosed multiple myeloma.
- Funding: Celgene; Janssen; Pierre Fabré; Spanish government.
- Optimal number of induction cycles and their length remain to be established.
- No comparator.