During a discussion of the results, Dr. Facon acknowledged that the survival difference between the Rd continuous and Rd 18 groups was marginal and said additional insights will come from the final survival analysis as well as the recently published quality of life analyses.
When asked whether he would prefer Rd to VMP (bortezomib, melphalan, and prednisone), Dr. Facon said both regimens are standards of care in transplant-ineligible myeloma patients and cautioned against making cross-trial comparisons between FIRST and the older VISTA study of VMP.
“I would just say that these two regimens are effective and safe regimens, and it is also a discussion with your patients,” he said. “You may say that’s an easy answer, but I think it’s a fair answer.”
In February, the Food and Drug Administration expanded the indication for lenalidomide in combination with dexamethasone to include patients with newly diagnosed multiple myeloma.
FIRST was funded by Intergroupe Francophone du Myélome and Celgene. Dr. Facon reported consulting for and honoraria from Celgene.
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