Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis

F. Gay, S Oliva, Maria T. Petrucci, V Montefusco, C. Conticello, P Musto, L. Catalano, A Evangelista, S. Spada, P. Campbell, R. Ria, M. Salvini, M. Offidani, A M Carella, P Omedé, A. M. Liberati, R Troia, A. M. Cafro, A Malfitano, A P FalconeT. Caravita, F. Patriarca, A. Nagler, Craig A. Spencer, Rom Hajek, A. A. Palumbo, M. Boccadoro

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m(2) and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54%, HR 0.53, P<0.001) and OS (4 years: 84 vs 70%, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53% of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.Leukemia advance online publication, 24 January 2017; doi:10.1038/leu.2016.381.

Original languageEnglish
JournalLeukemia
DOIs
Publication statusE-pub ahead of print - Jan 24 2017

Fingerprint

Autografts
Disease-Free Survival
Drug Therapy
Melphalan
Recurrence
Survival
lenalidomide
Publications
Leukemia

Keywords

  • Journal Article

Cite this

Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients : a pooled analysis. / Gay, F.; Oliva, S; Petrucci, Maria T.; Montefusco, V; Conticello, C.; Musto, P; Catalano, L.; Evangelista, A; Spada, S.; Campbell, P.; Ria, R.; Salvini, M.; Offidani, M.; Carella, A M; Omedé, P; Liberati, A. M.; Troia, R; Cafro, A. M.; Malfitano, A; Falcone, A P; Caravita, T.; Patriarca, F.; Nagler, A.; Spencer, Craig A.; Hajek, Rom; Palumbo, A. A.; Boccadoro, M.

In: Leukemia, 24.01.2017.

Research output: Contribution to journalArticle

Gay, F, Oliva, S, Petrucci, MT, Montefusco, V, Conticello, C, Musto, P, Catalano, L, Evangelista, A, Spada, S, Campbell, P, Ria, R, Salvini, M, Offidani, M, Carella, AM, Omedé, P, Liberati, AM, Troia, R, Cafro, AM, Malfitano, A, Falcone, AP, Caravita, T, Patriarca, F, Nagler, A, Spencer, CA, Hajek, R, Palumbo, AA & Boccadoro, M 2017, 'Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis', Leukemia. https://doi.org/10.1038/leu.2016.381
Gay, F. ; Oliva, S ; Petrucci, Maria T. ; Montefusco, V ; Conticello, C. ; Musto, P ; Catalano, L. ; Evangelista, A ; Spada, S. ; Campbell, P. ; Ria, R. ; Salvini, M. ; Offidani, M. ; Carella, A M ; Omedé, P ; Liberati, A. M. ; Troia, R ; Cafro, A. M. ; Malfitano, A ; Falcone, A P ; Caravita, T. ; Patriarca, F. ; Nagler, A. ; Spencer, Craig A. ; Hajek, Rom ; Palumbo, A. A. ; Boccadoro, M. / Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients : a pooled analysis. In: Leukemia. 2017.
@article{0cae39d2401b4349a6009b95eaf33ffe,
title = "Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients: a pooled analysis",
abstract = "In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m(2) and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54{\%}, HR 0.53, P<0.001) and OS (4 years: 84 vs 70{\%}, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53{\%} of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.Leukemia advance online publication, 24 January 2017; doi:10.1038/leu.2016.381.",
keywords = "Journal Article",
author = "F. Gay and S Oliva and Petrucci, {Maria T.} and V Montefusco and C. Conticello and P Musto and L. Catalano and A Evangelista and S. Spada and P. Campbell and R. Ria and M. Salvini and M. Offidani and Carella, {A M} and P Omed{\'e} and Liberati, {A. M.} and R Troia and Cafro, {A. M.} and A Malfitano and Falcone, {A P} and T. Caravita and F. Patriarca and A. Nagler and Spencer, {Craig A.} and Rom Hajek and Palumbo, {A. A.} and M. Boccadoro",
year = "2017",
month = "1",
day = "24",
doi = "10.1038/leu.2016.381",
language = "English",
journal = "Leukemia",
issn = "0887-6924",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Autologous transplant vs oral chemotherapy and lenalidomide in newly diagnosed young myeloma patients

T2 - a pooled analysis

AU - Gay, F.

AU - Oliva, S

AU - Petrucci, Maria T.

AU - Montefusco, V

AU - Conticello, C.

AU - Musto, P

AU - Catalano, L.

AU - Evangelista, A

AU - Spada, S.

AU - Campbell, P.

AU - Ria, R.

AU - Salvini, M.

AU - Offidani, M.

AU - Carella, A M

AU - Omedé, P

AU - Liberati, A. M.

AU - Troia, R

AU - Cafro, A. M.

AU - Malfitano, A

AU - Falcone, A P

AU - Caravita, T.

AU - Patriarca, F.

AU - Nagler, A.

AU - Spencer, Craig A.

AU - Hajek, Rom

AU - Palumbo, A. A.

AU - Boccadoro, M.

PY - 2017/1/24

Y1 - 2017/1/24

N2 - In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m(2) and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54%, HR 0.53, P<0.001) and OS (4 years: 84 vs 70%, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53% of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.Leukemia advance online publication, 24 January 2017; doi:10.1038/leu.2016.381.

AB - In newly diagnosed myeloma patients, upfront autologous transplant (ASCT) prolongs progression-free survival 1 (PFS1) compared with chemotherapy plus lenalidomide (CC+R). Salvage ASCT at first relapse may still effectively rescue patients who did not receive upfront ASCT. To evaluate the long-term benefit of upfront ASCT vs CC+R and the impact of salvage ASCT in patients who received upfront CC+R, we conducted a pooled analysis of 2 phase III trials (RV-MM-209 and EMN-441). Primary endpoints were PFS1, progression-free survival 2 (PFS2), overall survival (OS). A total of 268 patients were randomized to 2 courses of melphalan 200 mg/m(2) and ASCT (MEL200-ASCT) and 261 to CC+R. Median follow-up was 46 months. MEL200-ASCT significantly improved PFS1 (median: 42 vs 24 months, HR 0.53; P<0.001), PFS2 (4 years: 71 vs 54%, HR 0.53, P<0.001) and OS (4 years: 84 vs 70%, HR 0.51, P<0.001) compared with CC+R. The advantage was noticed in good and bad prognosis patients. Only 53% of patients relapsing from CC+R received ASCT at first relapse. Upfront ASCT significantly reduced the risk of death (HR 0.51; P=0.007) in comparison with salvage ASCT. In conclusion, these data confirm the role of upfront ASCT as the standard approach for all young myeloma patients.Leukemia advance online publication, 24 January 2017; doi:10.1038/leu.2016.381.

KW - Journal Article

U2 - 10.1038/leu.2016.381

DO - 10.1038/leu.2016.381

M3 - Article

C2 - 28008174

JO - Leukemia

JF - Leukemia

SN - 0887-6924

ER -