Multiple myeloma is one of the most common forms of bone or bone marrow cancer in Western countries. In addition to high-dose chemotherapy followed by a haematopoietic stem cell transplant, new drugs in particular have significantly improved the situation for those affected in recent years. As part of a multicentre study, German scientists have now compared the different treatment methods and investigated the role of a repeat haematopoietic stem cell transplant in advanced disease. They found that treatment with the new drugs alone can already achieve very good survival rates. Nevertheless, the group of patients who received a repeat haematopoietic stem cell transplant ultimately benefited.
The phase 3 trial compared two treatment pathways in patients with advanced multiple myeloma. 139 patients were to receive treatment with the drug lenalidomide and the corticosteroid dexamethasone, followed by high-dose chemotherapy and autologous haematopoietic stem cell transplantation, and subsequently maintenance therapy with lenalidomide. In the control arm, 138 patients were treated continuously with lenalidomide and dexamethasone without a blood stem cell transplant.
“It became apparent that the effect of high-dose chemotherapy and blood stem cell transplantation is less than previously assumed,” the researchers said, “nevertheless, patients for whom we can facilitate a repeat transplant appear to gain overall life expectancy as a result.”
References:
Heidelberg University Hospital, NCT – National Centre for Tumour Diseases
H. Goldschmidt, M.-A. Baertsch et al.: Salvage Autologous Transplant and Lenalidomide Maintenance vs. Lenalidomide/Dexamethasone for Relapsed Multiple Myeloma: the Randomised GMMG Phase III Trial ReLApsE. Leukemia, 21 July 2020;
https://doi.org/10.1038/s41375-020-0948-0
