Chakraborty R, et al. – This study was designed to investigate outcomes of maintenance therapy with lenalidomide (Len) or bortezomib (Bort) in multiple myeloma (MM) in the setting of early autologous stem cell transplantation. It was observed that post-transplant maintenance with Len or Bort was well tolerated in clinical practice. In addition, it improved progression-free survival (PFS) in high-risk subgroups of MM patients.

• 577 patients with newly diagnosed MM undergoing early auto-transplantation between 2010 and 2015, were examined.
• No, lenalidomide (Len) or bortezomib (Bort) maintenance, had been administered to 341, 132 and 104 patients.
• Data deisplayed a higher incidence of high-risk cytogenetics by fluorescence in situ hybridization (31% (Len) vs 58% (Bort) vs 8% (No); P<0.001) in patients receiving Len or Bort maintenance.
• As per observations, Len maintenance led to a superior progression-free survival (PFS) compared with no maintenance (median, 37 vs 28 months, respectively; P=0.002; adjusted hazard ratio 0.48 (95% CI, 0.35–0.66)), including in subgroups with ISS stage III disease (median, 40 vs 24 months; P=0.008) and high-risk cytogenetics (median, 27 vs 16 months; P=0.032).
• Although improved PFS in the high-risk cytogenetic subgroup, Bort maintenance did not confer PFS benefit for the entire cohort (median, 28 vs 16 months; P=0.035).
• Receiving Len or Bort maintenance, discontinuation due to toxicity was seen in 17 and 7% of patients.