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Carfilzomib, lenalidomide, and dexamethasone followed by salvage autologous stem cell transplant with or without maintenance for relapsed or refractory multiple myeloma

Salvage high-dose chemotherapy and autologous stem cell transplantation (HDCT/ASCT) is a treatment option for relapsed and/or refractory multiple myeloma (RRMM). No data are available on salvage HDCT/ASCT following re-induction treatment with state-of-the-art triplet regimens. We retrospectively rep...

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Main Authors: Bärtsch, Marc-Andrea (Author) , Fougereau, Mathilde (Author) , Hielscher, Thomas (Author) , Sauer, Sandra (Author) , Breitkreutz, Iris (Author) , Jordan, Karin (Author) , Müller-Tidow, Carsten (Author) , Goldschmidt, Hartmut (Author) , Raab, Marc-Steffen (Author) , Hillengaß, Jens (Author) , Giesen, Nicola (Author)
Format: Article (Journal)
Language:English
Published: 20 September 2021
In: Cancers
Year: 2021, Volume: 13, Issue: 18, Pages: 1-13
ISSN:2072-6694
DOI:10.3390/cancers13184706
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.3390/cancers13184706
Verlag, lizenzpflichtig, Volltext: https://www.mdpi.com/2072-6694/13/18/4706
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Author Notes:Marc-Andrea Baertsch, Mathilde Fougereau, Thomas Hielscher, Sandra Sauer, Iris Breitkreutz, Karin Jordan, Carsten Müller-Tidow, Hartmut Goldschmidt, Marc-Steffen Raab, Jens Hillengass and Nicola Giesen
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Summary:Salvage high-dose chemotherapy and autologous stem cell transplantation (HDCT/ASCT) is a treatment option for relapsed and/or refractory multiple myeloma (RRMM). No data are available on salvage HDCT/ASCT following re-induction treatment with state-of-the-art triplet regimens. We retrospectively report on 44 patients receiving salvage HDCT/ASCT following re-induction with carfilzomib/lenalidomide/dexamethasone (KRd). All patients received frontline HDCT/ASCT with median time to progression (TTP1) of 2.9 (1.2-13.5) years, enabling paired comparison of frontline and salvage HDCT/ASCT. After re-induction and before salvage transplant, 25/44 patients (57%) attained ≥ very good partial response (VGPR), which increased to 34/44 (77%) at best response after salvage HDCT/ASCT. Median progression-free survival (PFS) was 23.3 months from salvage HDCT/ASCT. Patients with ≥ VGPR at the time of salvage HDCT/ASCT and those receiving maintenance treatment post salvage HDCT/ASCT had significantly superior PFS (hazard ratio (HR) 0.19, p = 0.001 and HR 0.20, p = 0.009). In patients achieving at least an equal depth of response before salvage HDCT/ASCT as before frontline HDCT/ASCT, PFS after salvage HDCT/ASCT was comparable to the frontline situation (p = 0.3). This is the first report of state-of-the-art triplet re-induction and salvage HDCT/ASCT for RRMM after frontline transplantation. Deep remissions achieved with KRd translate into prolonged PFS following salvage HDCT/ASCT and are enhanced by maintenance treatment.
Item Description:Gesehen am 17.11.2021
This article belongs to the special issue "Autologous and allogeneic stem cell transplant in cancer therapy"
Physical Description:Online Resource
ISSN:2072-6694
DOI:10.3390/cancers13184706

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