Phase 3 trial of carfilzomib-lenalidomide-dexamethasone versus lenalidomide alone maintenance after autoSCT for multiple myeloma

The ongoing phase 3 ATLAS trial, at twelve centers in the USA and Polen, compares the combination of carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide alone (R) as maintenance therapy after any induction regimen followed by autologous stem-cell transplantation for newly diagnosed multipel myeloma. Interim analysis of the trial found median progression-free survival 59.1 months with the KRd combination versus 41.4 months with lenalidomide monotherapy (HR 0.51; p=0.012). Serious adverse events were reported in 30% versus 22%. There was one treatment-related death in the KRd group. The authors conclude that the interim analysis provides support for the use of the KRd combination in this setting. This conclusion requires confirmation after longer follow-up of the trial.