Carfilzomib, lenalidomide, and dexamethasone compared with lenalidomide treatment after autologous haematopoietic stem-cell transplantation in patients with multiple myeloma (ATLAS): primary analysis
3 hours ago
- #maintenance therapy
- #multiple myeloma
- #clinical trial
- The ATLAS trial compared carfilzomib-lenalidomide-dexamethasone (KRd) with lenalidomide alone as maintenance therapy post-autologous HSCT in multiple myeloma patients.
- KRd showed significantly improved 4-year progression-free survival (67.5%) compared to lenalidomide alone (38.0%), with a median PFS of 72.8 vs. 37.3 months (HR 0.46, p=0.0002).
- The study included 180 patients (92 in KRd, 88 in lenalidomide), with 47% female and 93% White participants, followed for a median of 69 months.
- Common grade 3-4 adverse events were neutropenia (48% KRd vs. 59% lenalidomide) and thrombocytopenia (13% vs. 6%). Serious adverse events occurred in 30% (KRd) and 23% (lenalidomide) of patients.
- Four treatment-related deaths were reported (two per group), with KRd deaths due to lung infections and lenalidomide deaths from COVID-19 and heart failure.
- The trial supports intensifying maintenance therapy with KRd, incorporating MRD-guided de-escalation for standard-risk patients, as a superior strategy to lenalidomide alone post-HSCT.