Lenalidomide vs bortezomib maintenance choice post-autologous hematopoietic cell transplantation for multiple myeloma. (June 2018)

• Record Type: Journal Article
• Authors: Huang, Jennifer; Phillips, Sharon; Byrne, Michael; Chinratanalab, Wichai; Engelhardt, Brian; Goodman, Stacey; Harrell, Shelton; Jagasia, Madan; Kassim, Adetola; Rawling, Kyle; Savani, Bipin; Sengsayadeth, Salyka; Cornell, R.
• Is Part Of: Bone marrow transplantation. Volume 53:Number 6(2018)
• Page Start: 701
• Page End: 707
• Publication Date: 2018-06
• Subjects: Bone marrow -- Transplantation -- Periodicals; 617.4410592
• DOI: 10.1038/s41409-018-0177-6
• Languages: English
• ISSNs: 0268-3369

Abstract

Abstract Maintenance therapy post-autologous hematopoietic cell transplantation (AHCT) with either lenalidomide or bortezomib for multiple myeloma (MM) have separately been shown to improve progression-free survival (PFS), but have never been directly compared. We performed a retrospective study to investigate progression-free and overall survival outcomes and toxicities of lenalidomide maintenance therapy compared with bortezomib maintenance in MM patients post-AHCT. This study included 156 patients who received post-AHCT lenalidomide or bortezomib maintenance therapy for MM. The primary outcome was PFS. Ninety-two patients received lenalidomide maintenance and 64 received bortezomib maintenance post-AHCT. By multivariable analysis, maintenance therapy choice and cytogenetics risk did not impact PFS or OS. Staging by International Staging System and pre-maintenance disease response were the greatest predictors for PFS. Treatment-related toxicities were as anticipated with 5.4% of patients receiving maintenance lenalidomide experiencing secondary primary malignancies (SPMs) compared with 3% for bortezomib. These findings suggest there were no differences in PFS or OS between lenalidomide and bortezomib maintenance therapy options for post-transplantation MM patients. These data should be validated in a larger, prospective cohort to determine if maintenance choice should be guided by side effect profile and patient anticipated tolerance rather than by disease biology alone.