Combo Rx plus stem-cell tx ups PFS in multiple myeloma

(HealthDay)—Combination therapy with lenalidomide, bortezomib, and dexamethasone (RVD) plus stem-cell transplantation is associated with longer progression-free survival than RVD alone for adults with multiple myeloma, according to a study published in the April 6 issue of the New England Journal of Medicine.

Michel Attal, M.D., from the Institut Universitaire du Cancer de Toulouse-Oncopole in France, and colleagues randomized patients with multiple myeloma to receive induction therapy with three cycles of RVD, then consolidation therapy with either five additional cycles of RVD (350 patients) or high-dose melphalan plus stem-cell transplantation followed by two additional RVD cycles (350 patients).

The researchers found that the group that underwent transplantation had significantly longer median progression-free survival compared to the group that received RVD alone (50 versus 36 months; adjusted hazard ratio for disease progression or death, 0.65; P < 0.001). This benefit was seen for all patient subgroups. The transplantation group had a higher percentage of patients with a complete response (59 versus 48 percent; P = 0.03) and a higher percentage of patients in whom minimal residual disease was not detected (79 versus 65 percent; P < 0.001). At four years there was no significant difference between the groups in overall survival (81 and 82 percent, respectively; P = 0.87).

"RVD therapy plus transplantation was associated with significantly longer progression-free survival than RVD therapy alone, but overall survival did not differ significantly between the two approaches," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Celgene, which funded the study.

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