Carfilzomib, lenalidomide, and dexamethasone maintenance for multiple myeloma: when and for whom?
Mené sur 180 patients atteints d'un myélome multiple (âge médian : 59 ans ; durée médiane de suivi : 33,8 mois), cet essai multicentrique de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité d'un traitement d'entretien par lénalidomide, seul ou en combinaison avec le carfilzomib et la dexaméthasone, après une greffe autologue de cellules souches
In The Lancet Oncology, Dominik Dytfeld and colleagues report interim findings of the ATLAS study, in which they compared carfilzomib, lenalidomide, and dexamethasone with lenalidomide alone as maintenance therapy after autologous stem-cell transplantation in patients with newly diagnosed multiple myeloma. Lenalidomide is the cornerstone of maintenance therapy and alternatives, especially for patients at high risk, have been intensively studied. However, previous trials did not randomly assign patients to lenalidomide, did not lead to licensing, and did not show superiority (even with more intensive regimens). Thus, the interim results of ATLAS were eagerly awaited. Previous maintenance alternatives included bortezomib (the first proteasome inhibitor), ixazomib (an oral proteasome inhibitor), carfilzomib, and CD38 antibodies. Several other alternatives remain in clinical trials.
The Lancet Oncology , commentaire, 2022