Dr. Jakubowiak on Improved Efficacy with ASCT+ KRd in Multiple Myeloma

Andrzej Jakubowiak, MD, PhD, professor of medicine, director, Myeloma Program, University of Chicago Medicine, discusses the impact of autologous stem cell transplant (ASCT) with kyprolis/revlimid/dexamethasone (KRd) for patients with newly diagnosed multiple myeloma.

In a phase II trial, patients were randomized to either receive KRd plus ASCT or KRd alone. Patients in the combination group received four 28-day cycles of induction therapy followed by stem cell collection (SCC), melphalan and ASCT, and then KRd consolidation. Patients then went on to receive KRd maintenance.

After KRD consolidation stringent complete response (sCR ) rates were 72% for KRd+ASCT group (n=50) compared to 30% for KRd-alone group (n=44). After maintenance therapy sCR rates were 88% (n=26) in the combination group versus 51% (n=41) in the KRd-alone group.

These data show that ASCT is still valid even with effective regimens like KRd available, says Jakubowiak.

The phase II study was an update to any earlier phase 1/2 trial looking at the same combination versus KRd alone. At 4-year follow-up of that study progression-free survival was 69% for patients treated with KRd+ ASCT. These results are some of the best seen in newly diangoised multiple myeloma, says Jakubowiak.