COMy 2022 | The role of consolidation therapy in MM and updates from the EMN02 trial

Consolidation therapy, the term consolidation therapy usually refers to a treatment phase which is given usually after, so not necessarily after transplant and is aimed at enhancing the rate of response in particular of MRD negativity. For this purpose, the same classes of novel agents given as induction before transplant are usually administered for a maximum up to four cycles after transplant.

Up to now, the role of a consolidation therapy has been prospectively evaluated in two studies. One of them was the EMN02 trial. In the second part of the EMN02 study, patients initially randomized to standard dose intensification therapy with VMP or high dose intensification therapy without the transplantation received a second randomization regardless of the first randomization to either two cycles of VRD or no consolidation. And results from the final analysis with a median follow up of approximately six years from second randomization supported the benefit of consolidation therapy and significantly extended the progression free survival in comparison with the control group. The progression-free survival benefit with consolidation therapy was retained in several pre-specified subgroups of patients, including those who were initially randomized to receive either VMP or transplant or a double autologous stem cell transplantation.