ASCO 2019: Predicting Early Relapse in Patients With Myeloma Treated With Triplet Regimens
Posted: Thursday, June 6, 2019
Previously, the FORTE trial demonstrated that regimens containing carfilzomib, lenalidomide, and dexamethasone (KRd) with and without autologous stem cell transplantation (ASCT) were equally effective in inducing high-quality responses in patients with newly diagnosed myeloma. In fact, both regimens were found to be superior to the triplet therapy of carfilzomib, cyclophosphamide, and dexamethasone (KCd) with ASCT. Now, a subgroup analysis of this trial based on risk status was presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago (Abstract 8002).
Francesca Gay, MD, of GIMEMA, European Myeloma Network, and colleagues revealed that about 50% of high-risk patients from both carfilzomib-based treatment groups achieved minimal residual disease negativity. In addition, ASCT reduced the risk of early relapse in these high-risk patients.
To recap the FORTE trial details, 474 patients with newly diagnosed multiple myeloma received KRd plus ASCT followed by 4 cycles of KRd consolidation; 12 cycles of KRd; or KCd induction plus ASCT and KCd consolidation. A total of 158 patients received carfilzomib-therapy with ASCT, and 157 patients received it without ASCT.
After a median follow-up of 25 months, the rates of very good partial response, complete response, stringent complete response, and minimal residual disease negativity were comparable with both carfilzomib-based regimens in patients with revised International Staging System (ISS) stage 1 and revised ISS stage 2 or 3 disease. The investigators reported that fewer patients treated with carfilzomib-based therapy and ASCT experienced early relapse than those treated with carfilzomib-based therapy without ASCT (8% vs. 17%). The authors credited the difference to a significantly lower rate of early relapse in patients with revised ISS stage 2 or 3 disease who were treated with carfilzomib-based therapy with and without ASCT (12% vs. 23%, respectively); no difference was seen in those patients with revised ISS stage 1 disease.
Disclosure: The study authors’ disclosure information may be found at coi.asco.org.
