Lenalidomide maintenance after autologous stem-cell transplantation (ASCT) in patients with newly-diagnosed multiple myeloma resulted in better overall and progression-free survival vs placebo or observation, according to a meta-analysis of 3 randomized trials involving more than 1,200 individuals. Participants were randomized to either lenalidomide maintenance (n=605) or placebo or observation (n=603). Among the results:

• Median progression-free survival was ~53 months in patients taking lenalidomide, vs ~24 months in the placebo/observation group.
• At a median follow-up of ~80 months for all surviving patients, the median overall survival had not been reached in the group taking lenalidomide, vs 86 months in the placebo/observation contingent.
• The cumulative incidence rate of a second primary malignancy before disease progression was higher with lenalidomide maintenance.
• Cumulative incidence rates of progression, death, or death as a result of myeloma were all higher with placebo/observation.