Selected studies of efficacy of salvage ASCT in MM
| Trial . | Design . | Patient group . | Reinduction at relapse . | Interval ASCT 1-relapse (months) . | Conditioning regimen . | Median PFS (months) . | Median OS (months) . |
|---|---|---|---|---|---|---|---|
| IFM 2009 – Perrot et al37 (2020) | Prospective, randomized, phase 3 | VRd alone | 40% Pom based | - | Mel 200 | 95 | 60.2% |
| VRd+ASCT | 46.5% Pom based | NR P = .76 | 62.2% P = .81 | ||||
| Cook et al34 (2016) | Prospective, randomized, phase 3 | Second ASCT, (n = 106) | 4 cycles of VAD | >24 | Mel 200 mg/m2 | 19 | 67 |
| Conventional chemotherapy (n = 106) | 30 | Oral cyclophosphamide 400 mg/m2 weekly × 12 weeks | 11 P < .0001 | 52 P = .016 | |||
| Gimsing et al44 (2015) | Prospective, nonrandomized phase 2 (n = 53) | 3 cycles of VD | 25.3 | Mel 200 mg/m2-bortezomib | 19.3 | 44.3 | |
| Ikeda et al45 (2019) | Retrospective (n = 526) | Allo-SCT (n = 192) | VT or R | <9 mo to >30 mo | - | Not done | Intermediate risk 21.5% |
| Re ASCT (n = 334). | 28.2% P < .004 | ||||||
| Gössi et al46 (2018) | Single-institution case-matched | Second ASCT, n = 61 | 28.9 | Age ≤70: Mel 200 mg/m2 Age >70: Mel 140 mg/m2 | 30.2 | 129.6 | |
| Conventional chemotherapy, n = 25 | RD or VD | 14.3 | 13 P = .0262 | 33.5 P = .0003 | |||
| Tremblay et al47 (2017) | Retrospective n = 74 | Conventional chemotherapy (89%); IMiD, 8%; PI, 59.5%; others, 5% | 53 | Mel ≥100 mg/m2 | 6.1 | 19.3 | |
| Singh Abbi et al48 (2015) | Retrospective n = 74 | Most patients received PIs and IMiDs | 37.7 | Mel ≥100 mg/m2 | 10.1 | 22.7 | |
| Grövdal et al49 (2015) | Multi-institution case-matched control analysis | Second ASCT, n = 111 | 28 | Mel 200 mg/m2 | 28 | 48 | |
| Conventional chemotherapy, n = 362 | 25 | 6 | 29 | ||||
| Novel drugs, n = 362 | PI and/or IMiD | 27 | 14 P = .004 | 39 P = .013 |
| Trial . | Design . | Patient group . | Reinduction at relapse . | Interval ASCT 1-relapse (months) . | Conditioning regimen . | Median PFS (months) . | Median OS (months) . |
|---|---|---|---|---|---|---|---|
| IFM 2009 – Perrot et al37 (2020) | Prospective, randomized, phase 3 | VRd alone | 40% Pom based | - | Mel 200 | 95 | 60.2% |
| VRd+ASCT | 46.5% Pom based | NR P = .76 | 62.2% P = .81 | ||||
| Cook et al34 (2016) | Prospective, randomized, phase 3 | Second ASCT, (n = 106) | 4 cycles of VAD | >24 | Mel 200 mg/m2 | 19 | 67 |
| Conventional chemotherapy (n = 106) | 30 | Oral cyclophosphamide 400 mg/m2 weekly × 12 weeks | 11 P < .0001 | 52 P = .016 | |||
| Gimsing et al44 (2015) | Prospective, nonrandomized phase 2 (n = 53) | 3 cycles of VD | 25.3 | Mel 200 mg/m2-bortezomib | 19.3 | 44.3 | |
| Ikeda et al45 (2019) | Retrospective (n = 526) | Allo-SCT (n = 192) | VT or R | <9 mo to >30 mo | - | Not done | Intermediate risk 21.5% |
| Re ASCT (n = 334). | 28.2% P < .004 | ||||||
| Gössi et al46 (2018) | Single-institution case-matched | Second ASCT, n = 61 | 28.9 | Age ≤70: Mel 200 mg/m2 Age >70: Mel 140 mg/m2 | 30.2 | 129.6 | |
| Conventional chemotherapy, n = 25 | RD or VD | 14.3 | 13 P = .0262 | 33.5 P = .0003 | |||
| Tremblay et al47 (2017) | Retrospective n = 74 | Conventional chemotherapy (89%); IMiD, 8%; PI, 59.5%; others, 5% | 53 | Mel ≥100 mg/m2 | 6.1 | 19.3 | |
| Singh Abbi et al48 (2015) | Retrospective n = 74 | Most patients received PIs and IMiDs | 37.7 | Mel ≥100 mg/m2 | 10.1 | 22.7 | |
| Grövdal et al49 (2015) | Multi-institution case-matched control analysis | Second ASCT, n = 111 | 28 | Mel 200 mg/m2 | 28 | 48 | |
| Conventional chemotherapy, n = 362 | 25 | 6 | 29 | ||||
| Novel drugs, n = 362 | PI and/or IMiD | 27 | 14 P = .004 | 39 P = .013 |
allo-SCT, allogenic transplantation; Mel, melphalan; Pom, pomalidomide; RD, revlimid-dexamethasone; TNT, next treatment; VAD; bortezomib-adriamycin-dexamethasone.