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Maintenance therapy with bortezomib and dexamethasone after autotransplantation for high-risk multiple myeloma

Bone Marrow Transplantation volume 55, pages 1865–1867 (2020)Cite this article

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Over the last two decades, the enrichment of therapeutic armamentarium for multiple myeloma (MM) with immunomodulatory drugs (IMiDs), proteasome inhibitors (PIs), and monoclonal antibodies (mAbs) translated into extended progression-free survival (PFS) and overall survival (OS). To prevent or delay relapse, maintenance therapy with lenalidomide is the standard of care for newly diagnosed (ND) patients after autologous stem-cell transplantation (ASCT) [1, 2]. Nevertheless, most patients, and particularly those with aggressive biological and clinical features, experience an inevitable relapse, primarily for the persistence of residual clonogenic cells.

Advanced International Staging System (ISS), extramedullary disease (EMD), and several cytogenetic abnormalities (CAs), including del(17p), t(4;14), t(14;16), t(14;20), and gain(1q), are the most relevant factors conferring poor prognosis. Data regarding the efficacy of lenalidomide maintenance in patients with high risk (HR) features are still conflicting [1, 2]. Meanwhile, some findings have suggested that post-ASCT treatment with the first in class PI bortezomib represents an effective maintenance strategy in HR cytogenetics patients [3]. Particularly, in a subanalysis of the randomized HOVON-65/GMMG-HD4 trial, bortezomib based induction followed by post-ASCT bortezomib maintenance was associated with improved PFS and OS for patients with del(17p) [4].

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References

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Authors and Affiliations

  1. Seràgnoli Institute of Hematology, Department of Experimental, Diagnostic and Specialty Medicine, Bologna University School of Medicine, S. Orsola Malpighi Hospital, Bologna, Italy

    Katia Mancuso, Paola Tacchetti, Lucia Pantani, Serena Rocchi, Ilaria Rizzello, Isola Caratozzolo, Gabriella De Cicco, Alessio Fusco, Nicoletta Testoni, Carolina Terragna, Giulia Marzocchi, Marina Martello, Enrica Borsi, Luca Dozza, Michele Cavo & Elena Zamagni

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  1. Katia Mancuso
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  2. Paola Tacchetti
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Correspondence to Michele Cavo.

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Conflict of interest

KM has received honoraria from Janssen, Celgene, Takeda, and Amgen. PT has received honoraria from Janssen, Celgene, Bristol-Myer Squibb, and Amgen. LP has received honoraria from Janssen, Celgene, and Takeda. MC has received honoraria and served on the advisory board for Janssen, Celgene, Bristol-Myer Squibb, Takeda, Amgen, and Novartis. EZ has received honoraria from and served on the advisory board for Janssen, Celgene, Bristol-Myer Squibb, Takeda, and Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the paper apart from those disclosed.

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Mancuso, K., Tacchetti, P., Pantani, L. et al. Maintenance therapy with bortezomib and dexamethasone after autotransplantation for high-risk multiple myeloma. Bone Marrow Transplant 55, 1865–1867 (2020). https://doi.org/10.1038/s41409-020-0844-2

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