Consolidation and Maintenance in Newly Diagnosed Multiple Myeloma

被引：22

作者：

Sonneveld, Pieter ^{[1
]}

Dimopoulos, Meletios A. ^{[2
]}

Beksac, Meral ^{[3
]}

van der Holt, Bronno ^{[4
]}

Aquino, Sara ^{[5
]}

Ludwig, Heinz ^{[6
]}

Zweegman, Sonja ^{[7
]}

Zander, Thilo ^{[8
]}

Zamagni, Elena ^{[9
,10
]}

Wester, Ruth ^{[1
]}

Hajek, Roman ^{[11
]}

Pantani, Lucia ^{[9
]}

Dozza, Luca ^{[12
]}

Gay, Francesca ^{[13
]}

Cafro, AnneMaria ^{[14
]}

De Rosa, Luca ^{[15
]}

Morelli, Annamaria ^{[16
]}

Gregersen, Henrik ^{[17
]}

Gulbrandsen, Nina ^{[18
]}

Cornelisse, Petra ^{[19
]}

Troia, Rosella ^{[13
]}

Oliva, Stefania ^{[13
]}

van de Velden, Vincent ^{[20
]}

Wu, KaLung ^{[21
]}

Ypma, Paula F. ^{[22
]}

Bos, Gerard ^{[23
]}

Levin, Mark-David ^{[24
]}

Pour, Luca ^{[25
]}

Driessen, Christoph ^{[26
]}

Broijl, Annemiek ^{[1
]}

Croockewit, Alexandra ^{[27
]}

Minnema, Monique C. ^{[28
]}

Waage, Anders ^{[29
]}

Hveding, Cecilie ^{[30
]}

van de Donk, Niels W. C. J. ^{[7
]}

Offidani, Massimo ^{[31
]}

Palumbo, Giuseppe A. ^{[32
]}

Spencer, Andrew ^{[33
]}

Boccadoro, Mario ^{[13
]}

Cavo, Michele ^{[34
]}

机构：

[1] Erasmus MC Canc Inst, Dept Hematol, POB 2040, NL-3000 CA Rotterdam, Netherlands

[2] Natl & Kapodistrian Univ Athens, Sch Med, Dept Clin Therapeut, Athens, Greece

[3] Ankara Univ, Dept Hematol, Sch Med, Ankara, Turkey

[4] Erasmus MC Canc Inst, HOVON Data Ctr, Dept Hematol, Rotterdam, Netherlands

[5] IRCCS Azienda Osped Univ San Martino, IST Inst Nazl Ric Sul Canc, Genoa, Italy

[6] Wilhelminen Canc Res Inst, Wilhelminenspital, Vienna, Austria

[7] Vrije Univ Amsterdam, Canc Ctr Amsterdam, Dept Hematol, Amsterdam UMC, Amsterdam, Netherlands

[8] Luzerner Kantonshosp, Med Oncol, Luzern, Switzerland

[9] Univ Bologna, IRCCS Azienda Osped, Ist Ematol Seragnoli, Bologna, Italy

[10] Univ Bologna, Dipartimento Med Specialist Diagnost & Sperimenta, Bologna, Italy

[11] Univ Hosp Ostrava, Ostrava, Czech Republic

[12] Bologna Univ, S Orsola Malpighi Hosp, Seragnoli Inst Hematol, Dept Expt Diagnost & Expt Med,Sch Med, Bologna, Italy

[13] Univ Torino, Azienda Osped Univ Citta Salute & Sci, Div Hematol, Myeloma Unit, Turin, Italy

[14] ASST Grande Osped Metropolitano, Milan, Italy

[15] Osped San Camillo Forlanini, Rome, Italy

[16] Civ Hosp, Dept Hematol Transfus Med & Biotechnol Santo Spir, Pescara, Italy

[17] Aalborg Univ Hosp, Dept Haematol, Aalborg, Denmark

[18] Oslo Univ Hosp, Dept Hematol, Oslo, Norway

[19] Erasmus MC Canc Inst, HOVON Data Ctr, Rotterdam, Netherlands

[20] Erasmus MC Canc Inst, Dept Immunol, Rotterdam, Netherlands

[21] ZNA Stuivenberg, Dept Hematol, Antwerp, Belgium

[22] Haga Ziekenhuis, Dept Hematol, The Hague, Netherlands

[23] Maastricht Univ Med Ctr, Maastricht, Netherlands

[24] Albert Schweitzer Ziekenhuis, Dordrecht, Netherlands

[25] Univ Hosp Brno, Brno, Czech Republic

[26] Kantonsspital, Dept Oncol Hematol, St Gallen, Switzerland

[27] Radboud Univ Nijmegen Med Ctr, Dept Hematol, Nijmegen, Netherlands

[28] Univ Med Ctr Utrecht, Dept Hematol, Utrecht, Netherlands

[29] St Olav Hosp, Dept Hematol, Trondheim, Norway

[30] Sahlgrens Univ Hosp, Gothenburg, Sweden

[31] AOU Osped Riuniti Ancona, Clin Ematol, Ancona, Italy

[32] Univ Catania, Dept Sci Med Chirurg & Tecnol Avanzate GF Ingrass, Catania, Italy

[33] Monash Univ, Dept Haematol, Alfred Hosp, Melbourne, Vic, Australia

[34] Univ Bologna, Dipartimento Med Specialist Diagnost & Sperimenta, Ist Ematol Seragnoli, IRCCS S Orsola Malpighi, Bologna, Italy

来源：

JOURNAL OF CLINICAL ONCOLOGY | 2021年 / 39卷 / 32期

关键词：

STEM-CELL TRANSPLANTATION; LENALIDOMIDE MAINTENANCE; OPEN-LABEL; DEXAMETHASONE; BORTEZOMIB; THERAPY; CONSENSUS; INDUCTION; IMPROVES; OUTCOMES;

D O I：

10.1200/JCO.21.01045

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

PURPOSE To address the role of consolidation treatment for newly diagnosed, transplant eligible patients with multiple myeloma in a controlled clinical trial. PATIENTS AND METHODS The EMN02/HOVON95 trial compared consolidation treatment with two cycles of bortezomib, lenalidomide, and dexamethasone (VRD) or no consolidation after induction and intensification therapy, followed by continuous lenalidomide maintenance. Primary study end point was progression-free survival (PFS). RESULTS Eight hundred seventy-eight eligible patients were randomly assigned to receive VRD consolidation (451 patients) or no consolidation (427 patients). At a median follow-up of 74.8 months, median PFS with adjustment for pretreatment was prolonged in patients randomly assigned to VRD consolidation (59.3 v 42.9 months, hazard ratio [HR] = 0.81; 95% CI, 0.68 to 0.96; P = .016). The PFS benefit was observed across most predefined subgroups, including revised International Staging System (ISS) stage, cytogenetics, and prior treatment. Revised ISS3 stage (HR, 2.00; 95% CI, 1.41 to 2.86) and ampl1q (HR, 1.67; 95% CI, 1.37 to 2.04) were significant adverse prognostic factors. The median duration of maintenance was 33 months (interquartile range 13-86 months). Response complete response (CR) after consolidation versus no consolidation before start of maintenance was 34% versus 18%, respectively (P < .001). Response >= CR on protocol including maintenance was 59% with consolidation and 46% without (P < .001). Minimal residual disease analysis by flow cytometry in a subgroup of 226 patients with CR or stringent complete response or very good partial response before start of maintenance demonstrated a 74% minimal residual disease-negativity rate in VRD-treated patients. Toxicity from VRD was acceptable and manageable. CONCLUSION Consolidation treatment with VRD followed by lenalidomide maintenance improves PFS and depth of response in newly diagnosed patients with multiple myeloma as compared to maintenance alone. (C) 2021 by American Society of Clinical Oncology

引用

页码：3613 / +

页数：17

共 50 条

[1] Consolidation and Maintenance Therapies for Newly Diagnosed Multiple Myeloma in the Era of Novel Agents
Nitya Nathwani
Jeremy T. Larsen
Prashant Kapoor
[J]. Current Hematologic Malignancy Reports, 2016, 11 : 127 - 136
[2] Consolidation and Maintenance Therapies for Newly Diagnosed Multiple Myeloma in the Era of Novel Agents
Nathwani, Nitya
Larsen, Jeremy T.
Kapoor, Prashant
[J]. CURRENT HEMATOLOGIC MALIGNANCY REPORTS, 2016, 11 (02) : 127 - 136
[3] Carfilzomib and dexamethasone induction with lenalidomide, clarithromycin and dexamethasone consolidation and lenalidomide maintenance for newly diagnosed multiple myeloma
Forsberg, Peter A.
Rossi, Adriana C.
Boyer, Angelique
Pearse, Roger N.
Pekle, Karen A.
Jayabalan, David
Lakritz, Stephanie
Flicker, Kari
Ribadeneyra, Drew
Liotta, Brielle
Ely, Scott
Boussi, Leora
Allan, John N.
Coleman, Morton
Niesvizky, Ruben
Mark, Tomer M.
[J]. AMERICAN JOURNAL OF HEMATOLOGY, 2021, 96 (12) : 1554 - 1562
[4] Maintenance therapy in newly diagnosed multiple myeloma: current recommendations
Brioli, Annamaria
Tacchetti, Paola
Zamagni, Elena
Cavo, Michele
[J]. EXPERT REVIEW OF ANTICANCER THERAPY, 2014, 14 (05) : 581 - 594
[5] Lenalidomide as maintenance for every newly diagnosed patient with multiple myeloma
Mateos, Maria-Victoria
Gonzalez de la Calle, Veronica
[J]. LANCET ONCOLOGY, 2019, 20 (01): : 5 - 6
[6] RVD Induction Followed by Consolidation with ASCT in Patients with Newly Diagnosed Multiple Myeloma
Luskin, Marlise R.
Campigotto, Federico
Richardson, Paul G.
Koreth, John
Ghobrial, Irene M.
Schlossman, Robert
Soiffer, Robert J.
Munshi, Nikhil C.
Warren, Diane
Gannon, Muriel
Finn, Kathleen
Anderson, Kenneth C.
Weller, Edie
Laubach, Jacob P.
[J]. BLOOD, 2011, 118 (21) : 1767 - 1768
[7] Ixazomib, lenalidomide and dexamethasone consolidation with randomized ixazomib or lenalidomide maintenance after autologous transplant in newly diagnosed multiple myeloma
Michael Slade
Thomas G. Martin
Nitya Nathwani
Mark A. Fiala
Michael P. Rettig
Feng Gao
Abhinav Deol
Francis K. Buadi
Jonathan L. Kaufman
Craig C. Hofmeister
Tara K. Gregory
Jesus Berdeja
Ajai Chari
Ashley Rosko
Ravi Vij
[J]. Leukemia, 2022, 36 : 2917 - 2921
[8] Quadruplets, Maintenance, and More: The Future of Therapy for Newly Diagnosed Multiple Myeloma
Krishnan, Amrita
[J]. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA, 2021, 21 : S159 - S160
[9] Ixazomib, lenalidomide and dexamethasone consolidation with randomized ixazomib or lenalidomide maintenance after autologous transplant in newly diagnosed multiple myeloma
Slade, Michael
Martin, Thomas G.
Nathwani, Nitya
Fiala, Mark A.
Rettig, Michael P.
Gao, Feng
Deol, Abhinav
Buadi, Francis K.
Kaufman, Jonathan L.
Hofmeister, Craig C.
Gregory, Tara K.
Berdeja, Jesus
Chari, Ajai
Rosko, Ashley
Vij, Ravi
[J]. LEUKEMIA, 2022, 36 (12) : 2917 - 2921
[10] Consolidation and maintenance therapy of multiple myeloma
Zojer, N.
Ludwig, H.
[J]. ONKOLOGE, 2014, 20 (03): : 242 - 249

← 1 2 3 4 5 →