IMWG consensus on maintenance therapy in multiple myeloma

Author:

Ludwig Heinz1,Durie Brian G. M.2,McCarthy Philip3,Palumbo Antonio4,San Miguel Jésus5,Barlogie Bart6,Morgan Gareth7,Sonneveld Pieter8,Spencer Andrew9,Andersen Kenneth C.10,Facon Thierry11,Stewart Keith A.12,Einsele Hermann13,Mateos Maria-Victoria5,Wijermans Pierre14,Waage Anders15,Beksac Meral16,Richardson Paul G.10,Hulin Cyrille17,Niesvizky Ruben18,Lokhorst Henk19,Landgren Ola20,Bergsagel P. Leif12,Orlowski Robert21,Hinke Axel22,Cavo Michele23,Attal Michel24

Affiliation:

1. Department of Medicine I, Center for Oncology and Hematology, Wilhelminenspital, Vienna, Austria;

2. Southwest Oncology Group, International Myeloma Foundation and Cedars Sinai Comprehensive Cancer Center, Los Angeles, CA;

3. Roswell Park Cancer Institute, Buffalo, NY;

4. Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliera Universitaria S. Giovanni Battista, Torino, Italy;

5. University Hospital of Salamanca, Salamanca, Spain;

6. Myeloma Institute for Research and Therapy, University of Arkansas for Medical Sciences, Little Rock, AR;

7. Haemato-Oncology Unit, Royal Marsden Hospital, London, United Kingdom;

8. Department of Hematology, Erasmus MC, Rotterdam, The Netherlands;

9. Clinical Haematology/Bone Marrow Transplant Department, Alfred Hospital, Melbourne, Victoria, Australia;

10. Dana-Farber Cancer Institute, Medical Oncology, Boston, MA;

11. Department of Hematology, Hospital Claude Huriez, Lille, France;

12. Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ;

13. Department of Internal Medicine II, University Hospital, Würzburg, Germany;

14. Haga Hospital, The Hague, The Netherlands;

15. Department of Hematology, St Olavs Hospital, Norwegian University of Science and Technology, Trondheim, Norway;

16. Department of Microbiology and Clinical Microbiology, Ankara University School of Medicine, Ibn-i Sina Hospital, Ankara, Turkey;

17. Hematology Department, University Hospital, Nancy, France;

18. Weill Cornell Medical College, New York, NY;

19. University Medical Center, Utrecht, The Netherlands;

20. Metabolism Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD;

21. Department of Lymphoma/Myeloma, Division of Cancer Medicine, University of Texas MD Anderson Cancer Center, Houston, TX;

22. WISP Research Institute, Langenfeld, Germany;

23. Seràgnoli Institute of Haematology, Bologna School of Medicine, S. Orsola's University Hospital, Bologna, Italy; and

24. Service d'Hématologie, Hospital Purpan, Toulouse, France

Abstract

Abstract Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/event-free survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.

Publisher

American Society of Hematology

Subject

Cell Biology,Hematology,Immunology,Biochemistry

Reference48 articles.

1. Lenalidomide plus melphalan and prednisone followed by lenalidomide maintenance provides favorable efficacy and health related quality-of-life in newly diagnosed multiple myeloma patients over 65 years [abstract].;Dimopoulos;Haematologica,2011

2. Remission maintenance therapy for multiple myeloma.;Alexanian;Arch Intern Med,1975

3. Unmaintained remissions in multiple myeloma.;Alexanian;Blood,1978

4. A randomized trial of maintenance versus no maintenance melphalan and prednisone in responding multiple myeloma patients.;Belch;Br J Cancer,1988

5. Interferon as therapy for multiple myeloma: an individual patient data overview of 24 randomized trials and 4012 patients.;Myeloma Trialists' Collaborative Group;Br J Haematol,2001

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3