Post‐transplant consolidation plus lenalidomide maintenance vs lenalidomide maintenance alone in multiple myeloma: A systematic review

Al-Ani, Fatimah; Louzada, Martha L

doi:10.1111/ejh.12961

Cited by 8 publications

(5 citation statements)

References 32 publications

(137 reference statements)

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“…Our analyses also demonstrated that, on multivariate analysis, 32 Similar findings were reported from a metaanalysis of consolidation plus lenalidomide maintenance vs lenalidomide maintenance alone, 33 although preliminary findings from the EMN02/HOVON-95 study showed contrasting results, with VRD vs no consolidation, followed by lenalidomide maintenance, resulting in improved PFS in patients aged ≤65 years. 34 Lenalidomide was approved as post-ASCT maintenance therapy in 2017 35 and was not a standard of care at the time of the MMY3012 and MMY3013 studies.…”

Section: Discussionsupporting

confidence: 84%

Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials

Straka

Knop

Vogel

et al. 2019

European J of Haematology

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Objective: A post hoc analysis of two phase III trials was carried out to explore the influence of age and treatment factors on the effect of bortezomib consolidation on progression-free survival (PFS) post autologous stem cell transplantation (ASCT). Methods:Patients with newly diagnosed multiple myeloma were assigned to one of two trials (ClinicalTrials.gov IDs: NCT00416273, NCT00416208), which were conducted in parallel, based on age (18-60 or 61-75 years, respectively). Following induction and ASCT, patients were randomized 1:1 to four 35-day cycles of bortezomib consolidation (1.6 mg/m 2 IV on days 1, 8,15,22) or observation only.

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Section: Discussionsupporting

confidence: 84%

Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials

Straka

Knop

Vogel

et al. 2019

European J of Haematology

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“…Consolidation after autologous stem cell transplantation has long been a point of discussion [26,27]. In our study, consolidation with six cycles of 25 mg of lenalidomide was feasible and no unexpected toxicity occurred.…”

Section: Discussionmentioning

confidence: 53%

Health-Related Quality of Life in Multiple Myeloma Patients Treated with High- or Low-Dose Lenalidomide Maintenance Therapy after Autologous Stem Cell Transplantation—Results from the LenaMain Trial (NCT00891384)

Boquoi,

Giagounidis,

Goldschmidt

et al. 2023

Cancers

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Introduction: The LenaMain trial (NCT00891384) reported increased progression-free survival with 25 mg of lenalidomide maintenance compared to 5 mg. Here, we report the patient-reported outcomes. Materials and Methods: Scores obtained from the EORTC Quality of Life Questionnaire C30 were analyzed for longitudinal changes from baseline within the groups as well as cross-sectional scores. Results: Compliance rates were high, with 95.7% at baseline and 70% during maintenance. At study entry, scores were high for functioning and low for symptoms. During maintenance, the median global health status/quality of life (GHS/QoL) was constant, without significant differences over time (median GHS/QoL: 68 at baseline and 58 for Len high and 68 for Len low at 2 years) and between treatment arms (mean change < 2). Similarly, most functional scale domains were constant. Notably, diarrhea increased consistently for both treatment arms (baseline: −1.905 (range: −5.78–1.97); end of year 2: 16.071 (range: 5.72–26.42); p < 0.05). The subgroup analysis showed that neither disease activity, duration of treatment, nor adverse events affected the health-related quality of life (HR-QoL) or utility. Conclusion: High baseline scores were maintained throughout the trial without significant differences between the Len dosages, which supports continuous treatment with a dose tailored to patients’ HR-QoL.

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“…A good partial response rate was approximately 1.5-fold significantly higher in the post-ASCT consolidation plus lenalidomide maintenance (CON + LEN) group than in the LEN alone group. [ 29 ] Patients treated with VTD presented a very good partial response rate than bortezomib, cyclophosphamide, and dexamethasone. [ 31 ]…”

Section: Resultsmentioning

confidence: 99%

“…This overview included 190 original RCTs and 57,142 participants. Seven reviews [27][28][29][30][31][32][33] discussed the efficacy and side effects of various drugs in combination with ASCT. Four reviews [34][35][36][37] focus on ASCT.…”

Section: Characteristics Of the Included Reviewsmentioning

confidence: 99%

Treatment of multiple myeloma based on autologous stem cell transplant: An overview of systematic reviews

Liang,

Yang,

et al. 2023

Medicine

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Background: Multiple myeloma (MM) is a malignant plasma cell disease. In recent years, several systematic reviews, and meta-analyses have been published on treatment protocols, including autologous stem cell transplantation for MM. Methods: Web of Science, PubMed, Embase, and Cochrane Library were searched to systematically summarize the quality of the methodology and evidence of meta-analyses regarding treatment of MM including autologous stem cell transplantation. Results: Total 11 meta-analyses were included. The preferred reporting items for systematic reviews and meta-analyses evaluation revealed that the quality of included reviews was affected by possible unevaluated bias between studies and the lack of protocol and registration. The AMSTAR2 scale indicated that the quality of the methodology of included reviews ranged from very low to moderate. The grading, assessment, development, and evaluation of recommendations evaluation showed that among the included outcome indicators, most of them are of low quality. Conclusion: This overview suggested that the combination of drugs has improved patient survival rates, efficacy and safety compared with the standard regimen. However, the strength of the evidence is uneven and due to methodological errors, the results should be interpreted with caution in order to provide a reference for further improvement of the study design. The methodological quality of the relevant meta-analysis needs to be further improved.

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Post‐transplant consolidation plus lenalidomide maintenance vs lenalidomide maintenance alone in multiple myeloma: A systematic review

Abstract: Background: In newly diagnosed multiple myeloma (NDMM), autologous stem cell

Cited by 8 publications

References 32 publications

Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials

Bortezomib consolidation following autologous transplant in younger and older patients with newly diagnosed multiple myeloma in two phase III trials

Health-Related Quality of Life in Multiple Myeloma Patients Treated with High- or Low-Dose Lenalidomide Maintenance Therapy after Autologous Stem Cell Transplantation—Results from the LenaMain Trial (NCT00891384)

Treatment of multiple myeloma based on autologous stem cell transplant: An overview of systematic reviews

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