Salvage treatment patterns in multiple myeloma patients progressing after lenalidomide maintenance: A real‐life study from European Myeloma Network ( EMN ) Italy
Year: 2026
Type: article
Study design: Observational Study
Abstract: The extensive use of lenalidomide (Len) in the first-line treatment of multiple myeloma (MM) has resulted in an increased frequency of patients who have been exposed or are refractory to Len (Len-R) at first relapse. However, the outcome of Len-R patients treated at first relapse after autologous haematopoietic stem cell transplantation (AHSCT) remains unclear. The aim of this real-life study is to evaluate the effectiveness of the regimens licensed in Italy and used in a cohort of patients who relapsed during Len maintenance after AHSCT. We collected 306 patients with these features. Considering the different regimens used, most patients received isatuximab-carfilzomib-dexamethasone (Isa-KD) (45.4%) followed by daratumumab-pomalidomide-dexamethasone (D-PD) (19.3%) and daratumumab-bortezomib-dexamethasone (D-VD) (12.4%). Overall, a reduced progression-free survival (PFS) and overall survival (OS) were observed in patients with high-risk disease features at relapse, including high lactate dehydrogenase (LDH) (p = 0.0003 and p < 0.0001), International Staging System (ISS) ≥2 (p < 0.0001 and p < 0.0001) and early relapse (<12 months from maintenance initiation) (p = 0.0017 and p = 0.0009). Considering the type of treatment, anti-cluster of differentiation 38 (CD38) monoclonal antibodies (anti-CD38 MoAb)-based regimen displayed improved survival compared to the other treatment, with Isa-KD reporting the longest PFS (22.8 months). Our data in a homogenous cohort of Len-R patients treated at first relapse demonstrated that the anti-CD38 MoAb-based combinations, particularly Isa-KD, represented the standard of care before the approval of anti-B cell maturation antigen (BCMA) immunotherapy.
Source: British Journal of Haematology
DOI: 10.1111/bjh.70751
Authors: Gregorio Barilà, Angela Grassi, Valeria Ruocco, Carmine Liberatore, Edoardo Olivari, Martina Tinelli, Francesca Fazio, Sonia Morè, Emanuele Favero, Claudio Salvatore Cartia, Nicola Sgherza, Concetta Conticello, Roberto Mina, Martina Gherardini, Giuseppe Mele, Massimo Gentile, Anna Furlan, Massimiliano Arangio Febbo, Maria Livia Del Giudice, Ombretta Annibali, Bernardo Rossini, Edoardo Scomazzon, Marco Talarico, Enrica Antonia Martino, Claudio De Magistris, Francesca Fioritoni, Anna Maria Cafro, Laura Paris, Sara Pezzatti, Roberta Della Pepa, Paola Boggione, Giuseppe Pietrantuono, Valeria Tomarchio, Francesco Vassallo, Maria Luisa Pioltelli, Francesco Pisani, Antonia Cagnetta, Lorenzo De Paoli, Gabriele Buda, Elisabetta Antonioli, Monica Galli, Alberto Tosetto, Pellegrino Musto, Elena Zamagni, Francesca Patriarca, Silvia Mangiacavalli, Renato Zambello, Massimo Offidani, Maria Teresa Petrucci
Institutions: Ospedale San Bortolo, Istituto Oncologico Veneto, University of Padua, Azienda Ospedale - Università Padova, University of Chieti-Pescara, Ospedale Papa Giovanni XXIII, University of Verona, Policlinico Umberto I, Sapienza University of Rome, Azienda Ospedaliero-Universitaria delle Marche, University of Udine, Policlinico San Matteo Fondazione, Azienda Universitaria Ospedaliera Consorziale - Policlinico Bari, University of Catania, Azienda Ospedaliero Universitaria Policlinico "G.Rodolico - San Marco", Azienda Ospedaliera Citta' della Salute e della Scienza di Torino, Ospedale A. Perrino, Azienda Ospedaliera di Cosenza, University of Calabria, Ca' Foncello Hospital, University of Pisa, Università Campus Bio-Medico, Campus Bio Medico University Hospital, Istituto Tumori Bari, Istituto di Ematologia di Bologna, University of Bologna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Federico II University Hospital, University of Naples Federico II, Università degli Studi del Piemonte Orientale “Amedeo Avogadro”, Centro di Riferimento Oncologico della Basilicata, Azienda Sanitaria Ospedaliera S.Croce e Carle Cuneo, Instituto Nazionale Tumori Regina Elena, Ospedale Policlinico San Martino, Azienda Ospedaliero-Universitaria Careggi, University of Bari Aldo Moro
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $5,190
OpenAlex ID: W7203695592