Clinical Autologous Transplantation: Results: Multiple Myeloma: Upfront Autologous Transplantation
121 Carfilzomib-Lenalidomide-Dexamethasone (KRd) Induction-Autologous Transplant (ASCT)-Krd Consolidation Vs Krd 12 Cycles Vs Carfilzomib-Cyclophosphamide-Dexamethasone (KCd) Induction-ASCT-Kcd Consolidation: Analysis of the Randomized Forte Trial in Newly Diagnosed Multiple Myeloma (NDMM)
Francesca Gay, MD,et al.
The Abstract concludes: Rates of MRD negativity, sCR, ≥CR, ≥VGPR were significantly higher with KRd-ASCT-KRd and KRd12 vs KCd. At present, no differences in MRD and overall best response (sCR, ≥CR, ≥VGPR) were noticed between KRd-ASCT-KRd and KRd12; longer follow-up is needed to evaluate survival. Treatment was well tolerated. Updated data will be presented at the meeting.
122 Progression Free Survival below 12 Months Following Stem Cell Transplant Is a Hallmark of High- Risk Myeloma Which Is Associated with Inferior Overall Survival - Data from the Ukmrc Myeloma XI Trial
Ceri A Bygrave, et al.
The Abstract concludes: Nearly three quarters of those with PFS1<12m had died 3 years after entry to MXI, highlighting an area of urgent unmet need for this poorly understood group. Continuous lenalidomide therapy and deep serological responses did not prevent early progression in some. At 36 months post ASCT 6% of patients with PFS1<12m had not progressed for a second time compared to 33% with a PFS1≥12 months. We found 64% of patients in the short PFS group had at least one HR genetic lesion. Current standard approaches lack efficacy to salvage patients, who have been exposed to immunomodulatory drugs and proteasome inhibitors and undergo early progression, despite variation in global access to other therapies. This justifies exploration of dedicated studies to characterise these patients at baseline and develop treatments that can improve their prognosis.
Ravi Vij, et al.
The Abstract concludes: IRd consolidation following ASCT appears to be safe and effective. The all oral regimen is convenient for patients which greatly simplifies follow-up in the peri-transplant period. Study enrollment is scheduled to complete in Q1 of 2019.
Michele Cavo, et al.
The Abstract concludes: Results of this pooled analysis of phase 3 studies incorporating bortezomib-based triplets into ASCT confirmed the superiority of ASCT-2 over ASCT-1 in terms of extended PFS and OS. The subgroup of pts at high-risk mostly benefited from ASCT-2, in particular those who had advanced ISS stage, adverse cyto and failed to achieve CR.
125 Bortezomib-Thalidomide-Dexamethasone Versus Thalidomide-Dexamethasone before and after Double Autologous Stem Cell Transplantation for Newly Diagnosed Multiple Myeloma: Final Analysis of Phase 3 Gimema-MMY-3006 Study and Prognostic Score for Survival Outcomes
Paola Tacchetti, et al.
The Abstract concludes: With a follow up of 10 yrs, the final analysis of the GYMEMA MMY-3006 trial comparing VTD versus TD showed a persistent PFS benefit translating into extended OS for the VTD arm. A prognostic model based on cytogenetic, ISS stage and achievement of CR, identified three risk groups with statistically different long-term survival probabilities. Both IR and HR groups significantly benefited from VTD. A PFS time of 78 months predicted for long term survival outcomes in the LR and IR groups.
Laura Rosinol Dachs, et al.
The Abstract concludes: Our long-term results confirm that induction with VTD results in a significantly longer PFS when compared with TD and VBMCP/VBAD/B. Patients with high-risk cytogenetics who achieved postransplant MRD negative had a similar outcome than patients with standard-risk cytogenetics, while patients with high-risk cytogenetics who remain MRD positive had a dismal prognosis. Finally, the PFS of 52 months achieved with VTD is the longest ever reported in the first line treatment of younger patients with MM elegible for ASCT and support the use of VTD as the standard of care for pretransplant induction therapy.