Author Interviews, Cancer Research, JAMA / 26.11.2018
Second Generation 3-Drug Combination Found Safe & Effective for Newly Diagnosed Multiple Myeloma
MedicalResearch.com Interview with:
Ola Landgren, MD, PhD
Professor of Medicine
Chief, Myeloma Service
Department of Medicine
Memorial Sloan Kettering Cancer Center
New York, NY 10065
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Meta-analysis show that minimal residual disease (MRD) negativity is a strong predictor of longer progression-free survival (PFS). Emerging data show that an increasing proportion of newly diagnosed multiple myeloma patients obtain MRD negativity after modern combination therapy, even in the absence of bone marrow transplant. The first generation of 3-drug combination therapy (RVd) was associated with quite high rates of peripheral neuropathy which may be life-long.
The current study was designed to define the rates of peripheral neuropathy in newly diagnosed multiple myeloma treated with the second generation of 3-drug combination therapy (KRd), and per default delayed transplant (i.e. collection of stem cells which were stored for potential future use).
This single arm, phase 2 study found no cases of grade 3 peripheral neuropathy. The rates of MRD negativity wereunprecedented; 28 of 45 patients achieved MRD-negative CR (62%). The durability of MRD-negative CR has been observed up to 70 months (median duration 52.4 months). Patients who achieved MRD negativity by the end of cycle 8 had a 78% reduced risk of progression. The results were regardless of age or cytogenetic risk category.
The results from this second generation of 3-drug combination therapy (KRd) without transplant, compare favorably to first generation of 3-drug combination therapy (RVd) followed by stem cell transplant.
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