Autologous Stem Cell Transplant Increases Survival in Multiple Myeloma Patients

Recent findings from a phase 3 clinical trial suggest that patients with multiple myeloma who received an autologous stem cell transplant (ASCT) had longer progression-free survival compared with patients who only received chemotherapy.

The study, which will be presented at the 2016 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, included 1266 patients newly diagnosed with multiple myeloma.

After induction therapy with bortezomib-cyclophosphamide-dexamethasone, patients were then randomized into a group who received bortezomib-melphalan-prednisone (VMP) or high-dose melphalan followed by single ASCT.

Patients in both treatment groups either received consolidation therapy with bortezomib-lenalidomide-dexamethasone or did not receive consolidation therapy. Maintenance therapy was given until disease progression or toxicity.

Researchers found that patients who underwent ASCT progressed more slowly compared with patients in the other cohort, according to the study. Patients in the ASCT cohort showed a 24% decreased risk of progression compared with patients who did not receive the transplant.

Researchers also found that patients in the ASCT cohort who were in advanced stages of the disease showed a 48% decreased risk of progressing compared with patients who did not undergo ASCT. Patients receiving ASCT showed an 84% chance of a tumor cell mass reduction of at least 90%.

Patients not receiving ASCT only had a 74% chance, according to the study. Since the study is still in progress, researchers said that additional analyses in the future will evaluate overall survival, toxicity, and quality of life.

“Our findings show that autologous stem cell transplant should remain the preferred treatment for patients with multiple myeloma age 65 and under,” said lead study author Michele Cavo, MD. “While transplant-free treatment with novel agents remains an intriguing prospect, the reality is that stem cell transplant remains a powerful and proven approach, and with novel agents playing a supporting role, it is more effective than ever.”