Startseite Kongressberichte 2017 59th ASH Annual Meeting and Exposition Multiple Myeloma Oral Sessions Myeloma: Therapy, excluding Transplantation: Upfront Therapy for Multiple Myeloma: Induction and Maintenance

653. Myeloma: Therapy, excluding Transplantation: Upfront Therapy for Multiple Myeloma: Induction and Maintenance

Sonja Zweegman, MD1, Bronno van der Holt2*, Fredrik H. Schjesvold, MD, PhD3, Mark-David Levin, PhD4, et al.

The authors of the study conclude that: 

Induction treatment with ITd in NDMM results in high overall response rate of 81%, with 44% ≥ VGPR. Median time to response was 1.1 month. In frail and high risk cytogenetic patients induction therapy with ITd was equally effective with respect to response. Therapy was found to be feasible with limited toxicity and a low resulting discontinuation rate of 15%, although in patients >80 years toxicity was higher.

Naoki Takezako, MD, PhD1, Kensuke Ohta, MD, PhD2*, Hiroshi Handa, MD, PhD, Mitsuo Hori, MD, PhD4, et al.

The authors of the study conclude that: 

In this first report of ELd treatment of pts with NDMM, the primary endpoint of ORR was met. ELd had an acceptable safety profile in this pt population, and an increased infusion rate of 5 mL/min, which reduced infusion time and did not induce additional IRs. These data suggested that ELd with a faster infusion rate of 5 mL/min was effective and well tolerated in Japanese pts with NDMM.


Hervé Avet-Loiseau, MD, PhD1*, Valerie Lauwers-Cances, MD2*, Jill Corre, PharmD, PhD3*, Philippe Moreau4*, et al.

The authors of the study conclude that: 

We showed that MRD could (should?) be considered as a novel surrogate biomarker for trial evaluation. This study showed that the best sensitivity is associated with the best discrimination in PFS and OS, and suggested that 10-6 should be the optimal cutoff.


Graham Jackson, MD, PhD1, Faith E Davies, MD2, Charlotte Pawlyn, BA, PhD, MBBChir, MRCP, FRCPath3, David Cairns, BSc, MSc, PhD4*, et al.

The authors of the study conclude that: 

The use of maintenance lenalidomide improves outcomes for newly diagnosed myeloma patients irrespective of risk status.


Krina K. Patel, MD, MSc1, Jatin J. Shah, MD2*, Lei Feng, MS3*, Hans C. Lee, MD4, et al.

The authors of the study conclude that: 

This updated data establishes that long term administration of combination of LenI as maintenance therapy post ASCT is feasible with pts ongoing at 51+ cycles. The incidence of adverse events was similar to historical experience with Len alone; hematologic adverse events were manageable with dose reductions. The incidence of PN was limited to grade 1/2 events and 6 grade 3 events with no other unexpected toxicity. The combination is safe, feasible, well tolerated and experience to date supports further exploration in phase III studies.


Andrew Branagan, MD1, Eamon Duffy2*, Connor Foster2*, Rakesh Verma, PhD3*, et al.

The authors of the study conclude that: 

We previously reported that a two dose strategy of Fluzone® High-Dose influenza vaccine is safely tolerated in patients with plasma cell disorders and associated with fewer laboratory-confirmed influenza infections. Unexpectedly, the current analysis revealed that protective HAI antibody titers rapidly fall in PCD patients. Typically, HAI titers slowly decrease following a peak protective response, but do not drop below protective levels until after 6 months. However, PCD patients in this study began to lose HAI seroprotection within 4 months and even as little as 30 days. Interestingly, patients who received the two dose series of high-dose influenza vaccine maintained higher rates of seroprotection at the end of the influenza season compared to those who received standard vaccination. The maintenance of seroprotection was greatest against the seasonal H1N1 strain (which was the predominate circulating strain during that particular 2015-2016 flu season). Importantly, these results suggest that a two dose series of high-dose vaccine provides may mitigate loss of vaccine-induced HAI titers and allow more durable serologic protection throughout the flu season. Studies are ongoing to further explore immune function following influenza vaccination, including cell-mediated responses. More studies are warranted to help determine the optimal dose and timing of influenza vaccination in PCD patients. Understanding the unique kinetics of serologic responses in PCD patients may have practice changing implications for other vaccines and therapies in this population.