Al-Ani F, et al. - Experts tried to gauge the efficacy of post-transplant consolidation plus lenalidomide maintenance vs. lenalidomide maintenance alone in multiple myeloma. Post-transplant consolidation appeared to improve the depth of response in newly diagnosed multiple myeloma (NDMM) patients treated with upfront autologous stem cell transplantation (ASCT). However, it did not add to OS or PFS, compared to lenalidomide maintenance alone.

Methods

• A systematic review of phase II/III studies was performed to compare the efficacy of post-ASCT consolidation plus lenalidomide maintenance (CON+LEN) vs. lenalidomide maintenance alone (LEN alone) in NDMM.
• By using fixed and random effects models, a meta-analysis was performed.

Results

• With 2,275 participants with NDMM treated with ASCT and lenalidomide maintenance, fourteen studies were included.
• Following two groups were identified: CON+LEN group (n=1,102), and LEN alone group (n=1,173).
• No statistically significant difference was observed in the complete response rate between the 2 groups [RR=1.1; 95%CI: 0.83-1.44; p=0.490].
• It was reported that very good partial response or better rate was around 1.5 fold significantly higher in the CON+LEN group compared to LEN alone group [RR: 1.46; 95%CI: 1.25-1.70; p<0.0001].
• No significant difference was noticed between the 2 groups regarding PFS [RR: 1.0; 95%CI: 0.92-1.08, p=0.929] and OS [RR: 0.9; 95%CI: 0.92-1.01; p=0.148] at 3-4 years follow up.
• Between the 2 groups (RR: 1.2; 95%CI: 0.84-1.92; p=0.2), the risk of secondary primary malignancy (SPM) was also similar.
• They found data on adverse events limited.