IMWG consensus on maintenance therapy in multiple myeloma

Heinz Ludwig, Brian G M Durie, Philip McCarthy, Antonio Palumbo, Jésus San Miguel, Bart Barlogie, Gareth Morgan, Pieter Sonneveld, Andrew Spencer, Kenneth C. Andersen, Thierry Facon, Alexander Keith Stewart, Hermann Einsele, Maria Victoria Mateos, Pierre Wijermans, Anders Waage, Meral Beksac, Paul G. Richardson, Cyrille Hulin, Ruben NiesvizkyHenk Lokhorst, Ola Landgren, Peter Leif Bergsagel, Robert Orlowski, Axel Hinke, Michele Cavo, Michel Attal

Research output: Contribution to journalArticle

151 Citations (Scopus)

Abstract

Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/eventfree survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.

Original languageEnglish (US)
Pages (from-to)3003-3015
Number of pages13
JournalBlood
Volume119
Issue number13
DOIs
StatePublished - Mar 29 2012

Fingerprint

Thalidomide
Multiple Myeloma
Consensus
Prednisone
Melphalan
Stem cells
Disease-Free Survival
Survival
Therapeutics
Transplants
Stem Cell Transplantation
Risk Reduction Behavior
Drug-Related Side Effects and Adverse Reactions
Pharmaceutical Preparations
Meta-Analysis
Bortezomib
Maintenance

ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Ludwig, H., Durie, B. G. M., McCarthy, P., Palumbo, A., San Miguel, J., Barlogie, B., ... Attal, M. (2012). IMWG consensus on maintenance therapy in multiple myeloma. Blood, 119(13), 3003-3015. https://doi.org/10.1182/blood-2011-11-374249

IMWG consensus on maintenance therapy in multiple myeloma. / Ludwig, Heinz; Durie, Brian G M; McCarthy, Philip; Palumbo, Antonio; San Miguel, Jésus; Barlogie, Bart; Morgan, Gareth; Sonneveld, Pieter; Spencer, Andrew; Andersen, Kenneth C.; Facon, Thierry; Stewart, Alexander Keith; Einsele, Hermann; Mateos, Maria Victoria; Wijermans, Pierre; Waage, Anders; Beksac, Meral; Richardson, Paul G.; Hulin, Cyrille; Niesvizky, Ruben; Lokhorst, Henk; Landgren, Ola; Bergsagel, Peter Leif; Orlowski, Robert; Hinke, Axel; Cavo, Michele; Attal, Michel.

In: Blood, Vol. 119, No. 13, 29.03.2012, p. 3003-3015.

Research output: Contribution to journalArticle

Ludwig, H, Durie, BGM, McCarthy, P, Palumbo, A, San Miguel, J, Barlogie, B, Morgan, G, Sonneveld, P, Spencer, A, Andersen, KC, Facon, T, Stewart, AK, Einsele, H, Mateos, MV, Wijermans, P, Waage, A, Beksac, M, Richardson, PG, Hulin, C, Niesvizky, R, Lokhorst, H, Landgren, O, Bergsagel, PL, Orlowski, R, Hinke, A, Cavo, M & Attal, M 2012, 'IMWG consensus on maintenance therapy in multiple myeloma', Blood, vol. 119, no. 13, pp. 3003-3015. https://doi.org/10.1182/blood-2011-11-374249
Ludwig H, Durie BGM, McCarthy P, Palumbo A, San Miguel J, Barlogie B et al. IMWG consensus on maintenance therapy in multiple myeloma. Blood. 2012 Mar 29;119(13):3003-3015. https://doi.org/10.1182/blood-2011-11-374249
Ludwig, Heinz ; Durie, Brian G M ; McCarthy, Philip ; Palumbo, Antonio ; San Miguel, Jésus ; Barlogie, Bart ; Morgan, Gareth ; Sonneveld, Pieter ; Spencer, Andrew ; Andersen, Kenneth C. ; Facon, Thierry ; Stewart, Alexander Keith ; Einsele, Hermann ; Mateos, Maria Victoria ; Wijermans, Pierre ; Waage, Anders ; Beksac, Meral ; Richardson, Paul G. ; Hulin, Cyrille ; Niesvizky, Ruben ; Lokhorst, Henk ; Landgren, Ola ; Bergsagel, Peter Leif ; Orlowski, Robert ; Hinke, Axel ; Cavo, Michele ; Attal, Michel. / IMWG consensus on maintenance therapy in multiple myeloma. In: Blood. 2012 ; Vol. 119, No. 13. pp. 3003-3015.
@article{787bf86c4f674e2389357ee225682359,
title = "IMWG consensus on maintenance therapy in multiple myeloma",
abstract = "Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/eventfree survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.",
author = "Heinz Ludwig and Durie, {Brian G M} and Philip McCarthy and Antonio Palumbo and {San Miguel}, J{\'e}sus and Bart Barlogie and Gareth Morgan and Pieter Sonneveld and Andrew Spencer and Andersen, {Kenneth C.} and Thierry Facon and Stewart, {Alexander Keith} and Hermann Einsele and Mateos, {Maria Victoria} and Pierre Wijermans and Anders Waage and Meral Beksac and Richardson, {Paul G.} and Cyrille Hulin and Ruben Niesvizky and Henk Lokhorst and Ola Landgren and Bergsagel, {Peter Leif} and Robert Orlowski and Axel Hinke and Michele Cavo and Michel Attal",
year = "2012",
month = "3",
day = "29",
doi = "10.1182/blood-2011-11-374249",
language = "English (US)",
volume = "119",
pages = "3003--3015",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "13",

}

TY - JOUR

T1 - IMWG consensus on maintenance therapy in multiple myeloma

AU - Ludwig, Heinz

AU - Durie, Brian G M

AU - McCarthy, Philip

AU - Palumbo, Antonio

AU - San Miguel, Jésus

AU - Barlogie, Bart

AU - Morgan, Gareth

AU - Sonneveld, Pieter

AU - Spencer, Andrew

AU - Andersen, Kenneth C.

AU - Facon, Thierry

AU - Stewart, Alexander Keith

AU - Einsele, Hermann

AU - Mateos, Maria Victoria

AU - Wijermans, Pierre

AU - Waage, Anders

AU - Beksac, Meral

AU - Richardson, Paul G.

AU - Hulin, Cyrille

AU - Niesvizky, Ruben

AU - Lokhorst, Henk

AU - Landgren, Ola

AU - Bergsagel, Peter Leif

AU - Orlowski, Robert

AU - Hinke, Axel

AU - Cavo, Michele

AU - Attal, Michel

PY - 2012/3/29

Y1 - 2012/3/29

N2 - Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/eventfree survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.

AB - Maintaining results of successful induction therapy is an important goal in multiple myeloma. Here, members of the International Myeloma Working Group review the relevant data. Thalidomide maintenance therapy after autologous stem cell transplantation improved the quality of response and increased progression-free survival (PFS) significantly in all 6 studies and overall survival (OS) in 3 of them. In elderly patients, 2 trials showed a significant prolongation of PFS, but no improvement in OS. A meta-analysis revealed a significant risk reduction for PFS/eventfree survival and death. The role of thalidomide maintenance after melphalan, prednisone, and thalidomide is not well established. Two trials with lenalidomide maintenance treatment after autologous stem cell transplantation and one study after conventional melphalan, prednisone, and lenalidomide induction therapy showed a significant risk reduction for PFS and an increase in OS in one of the transplant trials. Maintenance therapy with single-agent bortezomib or in combination with thalidomide or prednisone has been studied. One trial revealed a significantly increased OS with a bortezomib-based induction and bortezomib maintenance therapy compared with conventional induction and thalidomide maintenance treatment. Maintenance treatment can be associated with significant side effects, and none of the drugs evaluated is approved for maintenance therapy. Treatment decisions for individual patients must balance potential benefits and risks carefully, as a widely agreed-on standard is not established.

UR - http://www.scopus.com/inward/record.url?scp=84859196307&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84859196307&partnerID=8YFLogxK

U2 - 10.1182/blood-2011-11-374249

DO - 10.1182/blood-2011-11-374249

M3 - Article

C2 - 22271445

AN - SCOPUS:84859196307

VL - 119

SP - 3003

EP - 3015

JO - Blood

JF - Blood

SN - 0006-4971

IS - 13

ER -