P-332: Role of Consolidation Chemotherapy in the Real World for Multiple Myeloma Patients Undergoing Autologous Hematopoietic Cell Transplantation (auto-HCT)

Introduction: Consolidation therapy is treatment given for a short duration typically with the same regimen used for induction therapy after auto-HCT. Consolidation is generally used for multiple myeloma patients who have not achieved an adequate response post transplant. It has, however, been incorporated as part of the standard treatment into many clinical trials recently that use Dara-VRD as induction regimens. To date, no studies have been conducted to assess progression free survival for patients who received Dara-VRd followed by consolidation versus no consolidation. Additionally, while most of the clinical trials are conducted with the addition of consolidation, in the real world, it is often not used. As there are no guidelines to advise which patients should receive consolidation therapy, often high-risk individuals are selected. This study aims to assess PFS in patients who were treated with induction Dara-VRd followed by consolidation compared to patients who received induction Dara-VRd without consolidation.

Methods: This study included patients at Allegheny Health Network who were considered transplant eligible and received frontline treatment with Dara-VRd between January 1, 2019 and June 30, 2022. All patients were >18 years of age. Patients who received Dara-VRd in the noted time frame were evaluated to determine if they received consolidation therapy or not. The study also assessed the number of patients who received maintenance and their maintenance regimen. PFS was then analyzed comparing those that received consolidation and those without.

Results: The total number of patients who underwent induction with Dara-VRd included in this study was 14 (12 males and 2 females). The average median age in the study was 60. The median follow-up time was 19.3 months. Of these 14 patients, 10 received maintenance alone and 4 out of the 14 patients received consolidation in addition to maintenance. Our analysis showed no statistically significant difference (p-value 0.68) in PFS in patients who received consolidation compared to those who received maintenance alone. It was also noted that often the patients that were chosen to receive consolidation were considered high risk secondary to poor response to frontline therapy.

Conclusions: Most patients in the real world do not get consolidation unless considered high risk by their provider. No study exists to compare PFS in patients who receive induction with Dara-VRd followed by consolidation vs patients who don’t. This study, while limited to a small population of patients, exhibits that the addition of consolidation may not provide a substantial benefit for PFS and may not significantly impact patient outcomes. Further research with a larger patient population needs to be conducted to draw stronger conclusions.