| The following article features coverage from the Tandem Meetings 2022. Click here to read more of Cancer Therapy Advisor’s conference coverage. |
Lenalidomide maintenance appears superior to bortezomib-based maintenance after autologous stem cell transplant (ASCT) in certain patients with high-risk multiple myeloma (MM), according to a study presented at the Tandem Meetings 2022.
Among all patients with high-risk MM, there were no significant differences in progression-free survival (PFS) or overall survival (OS) between patients who received lenalidomide maintenance and those who received bortezomib-based maintenance.
However, among patients with any abnormality at chromosome 1q (Abn1q), lenalidomide was associated with superior PFS and OS.
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This retrospective study included 503 patients with high-risk MM who underwent ASCT within 12 months of diagnosis. There were 357 patients who received maintenance with lenalidomide alone and 146 who received bortezomib-based maintenance. Bortezomib-based maintenance included bortezomib monotherapy (n=85), bortezomib plus lenalidomide (n=58), and bortezomib plus another therapy (n=2).
The median age at diagnosis was 61 years in both treatment groups (overall range, 34-79 years). Men made up 45% of the bortezomib group and 55% of the lenalidomide group, and Abn1q was seen in 50% and 60% of patients, respectively.
The most common induction regimens (in the bortezomib and lenalidomide groups, respectively) were bortezomib plus lenalidomide and dexamethasone (67% and 82%) and bortezomib plus cyclophosphamide and dexamethasone (29% and 17%). Prior to transplant, most patients in each group had a very good partial response (VGPR) or better (59% and 60%).
The best response after ASCT was similar between the groups. The VGPR rate was 28% in the bortezomib group and 30% in the lenalidomide group. The rate of complete response (CR) or stringent CR was 53% and 55%, respectively.
In a multivariate analysis, there was no significant difference between the treatment groups for PFS (hazard ratio [HR], 1.28; 95% CI, 0.76-2.16; P =.355) or OS (HR, 2.08; 95% CI, 0.82-5.27; P =.123) in the overall cohort.
However, among patients with Abn1q, those who received bortezomib-based maintenance had significantly worse PFS (HR, 1.93; 95% CI, 1.20-3.13; P =.007) and OS (HR, 3.21; 95% CI, 1.34-7.70; P = .0092) than patients who received lenalidomide maintenance.
Disclosures: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Read more of Cancer Therapy Advisor’s coverage of Tandem Meetings 2022 by visiting the conference page.
Reference
Bumma N, Dhakal B, Fraser R, et al. Impact of bortezomib-based vs. lenalidomide maintenance therapy on outcomes of patients with high-risk multiple myeloma. Tandem Meetings 2022; April 23-26, 2022. Abstract 13.
