The following is a summary of “Real-world outcomes (RWO) with tandem transplantation in patients (pts) with newly diagnosed multiple myeloma (NDMM),” published in the 2024 ASCO Annual Meeting under the issue of Oncology by Parmar et al.

Although Stem cell transplant (SCT) with maintenance therapy (MT) is standard for NDMM, tandem SCT shows PFS and OS benefits for patients (pts) with high-risk cytogenetic abnormalities (HRCA). Still, its use remains low in clinical practice.

Researchers conducted a retrospective study to assess real-world outcomes (RWO) following tandem transplant (TT) compared to single stem cell transplant with maintenance therapy (STM).

They used de-identified data from the COTA real-world database derived from US center EMRs, covering pts diagnosed with NDMM (1/1/2012 to 1/1/23). The study utilized the Kaplan-Meier method to assess TTNT, OS, and follow-up time, reporting log-rank test P-values. The TTNT was defined in two ways: time from 1st SCT (2nd if TT) to next LOT initiation or death (TTNT1), and time from 2nd LOT post-SCT to next LOT initiation or death (TTNT2). Using the Cox proportional hazards method to estimate hazard ratios, a propensity score model was used to compare study cohorts. HRCA were pts with 17p(-), t(4;14), t(14;16), t(14;20), and 1q+.

The results showed 1,117 pts with a median diagnosis age of 60 years. Of these pts, 56.9% were male, 68.9% were white, and 32% had HRCA; 937 received STM, and 180 received TT with median follow-up times of 68 months (mos) and 39 mos, respectively. The TTNT1 median for TT vs. STM was 52.7 vs. 51 mos (P=0.85). The TTNT2 median for TT vs. STM was 33.9 vs. 11.8 mos (P<0.001). The median OS for TT vs. STM was NR vs. 108.1 mos (P<0.001). In the PS model, the TT group had a significantly lower hazard of TTNT2 and OS events (HRs 0.49 and 0.47, P<0.001 and P=0.01) compared to STM.

Investigators concluded that RWO showed tandem transplant led to improved PFS and OS for pts despite more high-risk cytogenetic abnormalities, with propensity score analysis supporting this finding.

Source: meetings.asco.org/abstracts-presentations/232794