Maintenance intensification after allogeneic HSCT: refining selection
Mené sur 180 patients atteints d'un myélome multiple (durée médiane de suivi : 69 mois), cet essai de phase III évalue l'efficacité, du point de vue de la survie sans progression, et la toxicité du lénalidomide seul ou en combinaison avec le carfilzomib et la dexaméthasone après une greffe autologue de cellules souches hématopoïétiques
In The Lancet Haematology, Dominik Dytfeld and colleagues1 report the findings from the phase 3 ATLAS trial, comparing carfilzomib–lenalidomide–dexamethasone with lenalidomide alone as maintenance therapy after autologous haematopoietic stem-cell transplantation (HSCT) in patients with newly diagnosed multiple myeloma. Lenalidomide monotherapy has long been the global standard of care in this setting, based on consistent improvements in progression-free survival and overall survival.2 With a median follow-up of nearly 6 years, carfilzomib–lenalidomide–dexamethasone maintenance significantly improved 4-year progression-free survival (67·5% [95% CI 56·2–76·4] vs 38·0% [27·6–48·2]; hazard ratio 0·46 [95% CI 0·30–0·70]) with a manageable safety profile. These findings provide evidence from a randomised trial showing that intensifying maintenance can enhance disease control and contribute meaningfully to the evolving post-transplantation landscape.
The Lancet Haematology , commentaire, 2026