Salvage Therapy Does Not Up Survival for Progressive Myeloma

For myeloma patients with progressive disease (PD) after induction therapy, deepening of response through salvage therapy is not associated with improved progression-free or overall survival, according to a study published online in Leukemia & Lymphoma.

Joanna Blocka, M.D., from the University Hospital of Heidelberg in Germany, and colleagues performed a retrospective analysis of 1,599 myeloma patients treated between 1991 and 2016 to examine whether patients with PD after induction should receive salvage therapy or proceed directly to autologous stem cell transplantation (ASCT).

The researchers found that progression-free and overall survival did not improve with deepening of response through salvage therapy (hazard ratios [HRs], 0.71 [95 percent confidence interval (CI), 0.28 to 1.80; P = 0.5] and 0.77 [95 percent CI, 0.30 to 1.95; P = 0.6], respectively), neither with treatment with novel agents (HRs, 0.66 [95 percent CI, 0.23 to 1.85; P = 0.4] and 0.76 [95 percent CI, 0.27 to 2.15; P = 0.6], respectively) nor with older regimens (HRs, 0.86 [95 percent CI, 0.36 to 2.07; P = 0.7] and 0.80 [95 percent CI, 0.34 to 1.91; P = 0.6], respectively).

"Considering this finding, the question arises, whether induction therapy is of any use at all," the authors write. "Although there is a general tendency to achieve a deep therapy response before ASCT, further analyses should be performed to answer this question."

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