Andrzej Jakubowiak, MD, PhD
INTERVIEWED BY The ASCO Post, Andrzej Jakubowiak, MD, PhD, Director of the Multiple Myeloma Program at the University of Chicago Medical Center, commented on the “controversial findings” of EMN02/HO95. “This European study has opened the gate toward showing the benefit of a second transplant, particularly in high-risk patients, which is something we did not see in the STaMINA trial in the United States, perhaps because our induction was more effective,” he said. “Dr. Cavo’s argument is, to some extent, something that most of us [transplanters] will use in our discussions, but in real practice second transplant is not very relevant.”
Dr. Jakubowiak explained that current induction regimens yield excellent responses in most patients. “In my center, for patients with a very good partial response or better, we typically discuss a second transplant, but only 5% to 10% are considered for second transplant because most patients have such a good response,” he said. “If you cannot reduce the risk well enough with induction, then a second transplant can help, but we do it infrequently.”
“I do believe the STaMINA study was informative and probably falls more in line with American practice,” he said. “But on the other hand, the Cavo study adds to what we have seen in a few centers (including Northwestern, University of Chicago, and Mount Sinai): tandem transplant can provide superior survival. I personally am unlikely to change practice based on these results, but it’s the strongest support for tandem transplant I have ever seen.” ■
DISCLOSURE: Dr. Jakubowiak reported no conflicts of interest.
FOR NEWLY DIAGNOSED patients with multiple myeloma considered to be at high risk of disease progression, double autologous stem cell transplantation (ASCT) significantly prolongs progression-free and overall survival, vs single transplant, according to the phase III EMN02/HO95 study. The findings...