Multicenter phase 3 trial of ixazomib consolidation and maintenance after salvage autologous stem-cell transplantation for relapsed multiple myeloma

The efficacy of consolidation and maintenance in the context of salvage autologous hematopoietic stem-cell transplantation (autoHSCT) for relapsed multiple myeloma (MM) is not clear. The phase 3 ACCorD trial, at 79 hospitals in the UK, evaluated ixazomib, thalidomide, and dexamethasone consolidation, followed by ixazomib monotherapy maintenance after salvage autoHSCT for relapsed MM. Patients were randomized to consolidation and maintenance therapy (n=103) or observation. Interim analysis after a median follow-up of 27 months found that median progression-free survival was 20 months in the consolidation and maintenance group versus 13 months in the observation group. Serious adverse events were reported for 32% of patients in the consolidation and maintenance group compared with 7% in the observation group. No deaths in the consolidation and maintenance group were deemed treatment related. The authors conclude that the ACCorD regimen improved progression-free survival after salvage autoHSCT for relapsed MM.