Evidence map›Paper›PMID 37021929›Full record

ArticleCancer2023

Impact of bortezomib-based versus lenalidomide maintenance therapy on outcomes of patients with high-risk multiple myeloma.

Naresh Bumma, Binod Dhakal, Raphael Fraser, Noel Estrada-Merly, Kenneth Anderson, César O Freytes, Gerhard C Hildebrandt, Leona Holmberg, Maxwell M Krem, Cindy Lee and 16 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Article
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  5. Review
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  8. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

26 authors.

Naresh BummaJames Cancer Center, Ohio State Medical Center, Columbus, Ohio, USA.
Binod DhakalBone Marrow Transplant and Cellular Therapy Program, Division of Hematology/Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.ORCID 0000-0002-4377-9742
Raphael FraserDivision of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Noel Estrada-MerlyCenter for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Kenneth AndersonDana-Farber Cancer Institute, Boston, Massachusetts, USA.
César O FreytesBone Marrow Transplant Program, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
Gerhard C HildebrandtMarkey Cancer Center, University of Kentucky, Lexington, Kentucky, USA.
Leona HolmbergFred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Maxwell M KremDivision of Hematology/BMT, Kansas City Veterans Affairs Medical Center, Kansas City, Missouri, USA.
Cindy LeeDepartment of Hematology, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Lazaros LekakisDivision of Transplantation and Cellular Therapy, University of Miami Hospital and Clinics, Sylvester Comprehensive Cancer Center, Miami, Florida, USA.
Hillard M LazarusUniversity Hospital Seidman Cancer Center, Case Western Reserve University, Cleveland, Ohio, USA.
Hira MianDepartment of Oncology, McMaster University, Hamilton, Ontario, Canada.ORCID 0000-0003-1584-1067
Hemant S MurthyBlood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida, USA.
Sunita NathanSection of Bone Marrow Transplant and Cell Therapy, Division of Hematology, Oncology, and Cell Therapy, Rush University Medical Center, Chicago, Illinois, USA.
Taiga NishihoriDepartment of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA.ORCID 0000-0002-2621-7924
Ricardo ParrondoBlood and Marrow Transplantation Program, Division of Hematology-Oncology, Mayo Clinic, Jacksonville, Florida, USA.ORCID 0000-0002-9314-9933
Sagar S PatelTransplant and Cellular Therapy Program, Huntsman Cancer Center Institute, University of Utah, Salt Lake City, Utah, USA.
Melhem SolhThe Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, Georgia, USA.
Christopher StrouseDivision of Hematology, Oncology, and Bone Marrow Transplantation, University of Iowa, Iowa City, Iowa, USA.
David H VesoleJonn Theurer Cancer Center at Hackensack University Medical Center, Hackensack, New Jersey, USA.
Shaji KumarHematology/Oncology, Mayo Clinic, Rochester, Minnesota, USA.ORCID 0000-0001-5392-9284
Muzaffar H QazilbashDepartment of Blood and Marrow Transplantation, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.ORCID 0000-0003-2876-2886
Nina ShahDivision of Hematology-Oncology, University of California San Francisco, San Francisco, California, USA.ORCID 0000-0002-1971-8173
Anita D'SouzaCenter for International Blood and Marrow Transplant Research (CIBMTR), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.ORCID 0000-0002-1092-5643
Surbhi SidanaDivision of Blood and Marrow Transplantation, Department of Medicine, Stanford Health Care, Stanford, California, USA.

Funding

Data Resource for Analyzing Blood &Marrow TransplantsU24CA076518 · NCI · MEDICAL COLLEGE OF WISCONSIN · PI Amy M Moskop, Bronwen Shaw · 1998 to 2026
$105.2M
Project 4: Targeting Resistance to T-Cell Directed Therapy in Multiple MyelomaP50CA186781 · NCI · MAYO CLINIC ARIZONA · PI Saad J. Kenderian · 2015 to 2026
$25.5M
Institutional Career Development Core (KL2)KL2TR003143 · NCATS · STANFORD UNIVERSITY · PI ASCH, STEVEN M. · 2019 to 2023
$8.7M
NCATS NIH HHS KL2 TR003143NCI NIH HHS P50 CA186781NCI NIH HHS U24 CA076518
6 · The paper itself

Abstract

backgroundLenalidomide maintenance after autologous stem cell transplant (ASCT) in multiple myeloma (MM) results in superior progression-free survival and overall survival. However, patients with high-risk multiple myeloma (HRMM) do not derive the same survival benefit from lenalidomide maintenance compared with standard-risk patients. The authors sought to determine the outcomes of bortezomib-based maintenance compared with lenalidomide maintenance in patients with HRMM undergoing ASCT.

methodsIn total, the authors identified 503 patients with HRMM who were undergoing ASCT within 12 months of diagnosis from January 2013 to December 2018 after receiving triplet novel-agent induction in the Center for International Blood and Marrow Transplant Research database. HRMM was defined as deletion 17p, t(14;16), t(4;14), t(14;20), or chromosome 1q gain.

resultsThree hundred fifty-seven patients (67%) received lenalidomide alone, and 146 (33%) received bortezomib-based maintenance (with bortezomib alone in 58%). Patients in the bortezomib-based maintenance group were more likely to harbor two or more high-risk abnormalities and International Staging System stage III disease (30% vs. 22%; p = .01) compared with the lenalidomide group (24% vs. 15%; p < .01). Patients who were receiving lenalidomide maintenance had superior progression-free survival at 2 years compared with those who were receiving either bortezomib monotherapy or combination therapy (75% vs. 63%; p = .009). Overall survival at 2 years was also superior in the lenalidomide group (93% vs. 84%; p = .001).

conclusionsNo superior outcomes were observed in patients with HRMM who received bortezomib monotherapy or (to a lesser extent) in those who received bortezomib in combination as maintenance compared with lenalidomide alone. Until prospective data from randomized clinical trials are available, post-transplant therapy should be tailored to each patient with consideration for treating patients in clinical trials that target novel therapeutic strategies for HRMM, and lenalidomide should remain a cornerstone of treatment.

Indexed as

Hematopoietic Stem Cell TransplantationMultiple MyelomaAntineoplastic Combined Chemotherapy ProtocolsBortezomibDexamethasoneHumansLenalidomideProspective StudiesTransplantation, AutologousBortezomibDexamethasoneLenalidomidebortezomiblenalidomidemaintenance therapymultiple myelomastem cell transplant

Identifiers

PMID37021929
PMCPMC10516285

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.