Ongoing transplant phase III trials for myeloma

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Published: 2 Mar 2017
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Dr Amrita Krishnan - City of Hope Cancer Center, Duarte, USA

Dr Krishnan speaks with ecancer at the 16th International Myeloma Workshop about phase III trials in myeloma looking at optimal post transplant approaches to improve response.

Autologous stem cell transplantation has been shown to improve progression free survival compared to standard dose chemotherapy for multiple myeloma in several phase III trials.

However, despite major improvements in response to treatment, relapse remains the major cause of mortality.

We now have sufficient evidence to justify the upfront use of autologous stem cell transplantation for suitable patients with myeloma.

The use of maintenance therapy post transplant also can be justified on the basis of several randomised trials.

Consolidation therapy remains a matter of controversy which may become clearer as the data from two large trials one in the US and one in Europe matures.

The most definitive thing to note is that in all these trials overall survival is encouraging and suggests that we continue to advance in our therapy of multiple myeloma.

Dr Krishnan also spoke with ecancer about the StaMINA trial of transplant in high risk patients.

ecancer's filming has been kindly supported by Amgen through the ECMS Foundation. ecancer is editorially independent and there is no influence over content.


What we talked about at today’s session was the StaMINA trial again, then we talked about the EMN trial. We talked about the IFM Dana Farber trial which was another huge randomised trial between the US and France looking at that question of early high dose therapy versus standard RVD induction therapy and that trial showed clearly a progression free survival benefit to early high dose therapy. That trial, also what we discussed today, had some consolidation after the initial high dose therapy and we saw increased responses. So our take home from today’s session, and it was probably a biased session because it was all transplant, was that transplant remains standard of care; early transplant improves progression free survival and the onus on us is really more just how do we improve upon transplant.