As per the 2010 ASCO meeting and the two studies presented there, maintenance treatment is beneficial after an autologous transplant for multiple myeloma and the CALGB s100104 study was stopped based on positive results. That trial of 568 multiple myeloma patients ages 18 to 70 included participants who had an autologous stem cell transplant. 460 patients were randomized to receive Revlimid maintenance therapy or placebo. Due to the significant difference in time to progression between the two groups, the study has been stopped, patients have been informed about which maintenance therapy they were receiving, and all patients have been given the option to receive Revlimid.
There is also randomized and phase II evidence to support maintenance thalidomide. In a 2012 NEJM study, Lenalidomide maintenance after transplantation significantly prolonged progression-free and event-free survival among patients with multiple myeloma. Four years after randomization, overall survival was similar in the two study groups. NCCN has incorporated lenalidomide maintenance, as well as interferon, steroids and thalidomide with or without prednisone into its guidelines. NCCN supports Revlimid maintenance after allogeneic or autlogous transplant.
NCCN.org, Multiple Myeloma. MYEL-6
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