Triple-drug therapy for post-transplant management of multiple myeloma (49% death reduction)

Medical Xpress / University of Chicago Medical Center / The Lancet Oncology ^ | Jan. 13, 2023 | Dominik Dytfeld et al

[ConservativeMind]

Researchers report promising results from their ongoing ATLAS trial.

The results indicate that maintenance therapy (a term researchers use to describe therapy with aim to preventing disease progression or death) with a combination of three drugs, carfilzomib, lenalidomide, and dexamethasone (known as KRd) may improve progression-free survival (a term clinicians use to describe the time to disease progression or death) when compared to the current standard of single agent lenalidomide treatment in patients with newly diagnosed multiple myeloma who have undergone initial induction treatment followed by autologous stem cell transplantation.

The KRd arm received either 8 or 36 cycles of KRd treatment based on the minimal residual disease (MRD) status—the amount of cancer cells that remain in the body during or after treatment—and presence or absence of disease risks for progression. Patients who had standard risk disease and achieved MRD-negativity at the end of 6 cycles of KRd maintenance, received a total 8 cycles of KRd followed by lenalidomide maintenance, the remaining patients continued KRd for 36 cycles followed by lenalidomide maintenance.

After median follow-up of 33.8 months, median progression-free survival for the KRd arm was 59.1 months compared to 41.6 months for the lenalidomide arm, which represents a 49% reduction in the risk of progression or death. This risk reduction was observed despite a shorter duration (8 cycles) of KRd treatment in 44% patients on the KRd arm with standard risk and MRD-negativity after cycle 6. The improvement of progression-free survival was associated with higher rate of MRD-negativity in the KRd arm compared to the lenalidomide arm at the completion of 6 cycles (53% vs 31%). As expected, patients in the KRd-treated arm experienced higher rates of toxicity but the differences did not translate into higher rates of treatment discontinuation or dose reductions.

[ConservativeMind]

This newer therapy appears a positive option.

[ConservativeMind]

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[HollyB]

Dexamethasone was also included in my conditioning.

[small business owner]

I was diagnosed with multiple myeloma 6 months ago and the treatment I am on is a real but-kicker. I have lost considerable weight and have had two recent heart attacks. My heart goes out to anyone with this disease