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The following is a summary of “Ixazomib as consolidation and maintenance versus observation in patients with relapsed multiple myeloma eligible for salvage autologous stem-cell transplantation (Myeloma XII [ACCoRD]): interim analysis of a multicentre, open-label, randomised, phase 3 trial,” published in the September 2024 issue of Hematology by Cook et al.
The effectiveness of consolidation and maintenance therapy after salvage autologous hematopoietic stem-cell transplantation for relapsed multiple myeloma (MM) remains uncertain.
Researchers conducted a retrospective study evaluating the impact of ixazomib consolidation and maintenance vs. observation in patients eligible for salvage autologous stem-cell transplantation.
They performed an interim analysis of the Myeloma XII (ACCoRD) trial, a multicenter, open-label, randomized, phase 3 study involving 206 patients across 79 hospitals in the UK. Patients aged 18 years or older with relapsed MM and adequate organ function were randomly assigned (1:1) to receive ixazomib, thalidomide, and dexamethasone for consolidation, followed by maintenance with ixazomib or observation. The primary endpoint was PFS, analyzed by intention-to-treat.
The results showed that a median follow-up of 27 months (IQR 13-38), the median PFS was 20 months (95% CI 15-29) in the consolidation and maintenance group and 13 months (11-18) in the observation group, resulting in HR of 0.55 (95% CI 0.39-0.78; P=0.0006). Serious AEs occurred in 29 (32%) of 92 patients in the consolidation and maintenance group compared to 7 (7%) of 103 patients in the observation group, with infections being the most common.
They concluded that ixazomib consolidation and maintenance following salvage autologous stem-cell transplantation can enhance treatment response durability in patients with relapsed MM.
Source: thelancet.com/journals/lanhae/article/PIIS2352-3026(24)00249-7/fulltext
