Saad Z. Usmani, MD, MBA, FACP, Explores Data Investigating Induction and Maintenances Approaches in High-Risk, Newly Diagnosed Myeloma

Saad Z. Usmani, MD, MBA, FACP, spoke about key takeaways from the phase 1/2 SWOG 1211 trial and top research presented at ASCO 2022 in multiple myeloma.

CancerNetwork® spoke with Saad Z. Usmani, MD, MBA, FACP, chief of the Myeloma Service at Memorial Sloan Kettering Cancer Center in New York, at the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting about key takeaways from the phase 1/2 SWOG 1211 trial (NCT01668719) examining induction and maintenance with lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) with or without elotuzumab (Empliciti) in patients with newly diagnosed, high-risk multiple myeloma.1 Although the trial failed to show a statistically significant benefit of the experimental treatment, Usmani said investigators can use these data to glean insights regarding the use of proteasome inhibitor (PIs) and immunomodulatory drugs (IMiD) in this setting.


The key message from a clinical practice perspective is that for patients with high-risk disease, a proteasome inhibitor and IMiD–based maintenance strategy is important, whether it’s in the transplant-eligible or -ineligible setting. The SWOG 1211 trial included patients who deferred their stem cell transplant or were transplant ineligible. There are data sets, such as the RVd 1000 study from the Emory University [Winship Cancer Institute],2 where similar kinds of approaches have been done for transplant-eligible patients. The message [across these datasets are indicating] to do something different for maintenance in the high-risk [setting] by combining PIs and IMiDs.


  1. Usmani SZ, Hoering A, Ailawadhi S, et al. Randomized phase II trial of bortezomib, lenalidomide, dexamthasone with/without elotuzumab for newly diagnosed, high risk multiple myeloma (SWOG-1211). J Clin Oncol. 2022;40(suppl 16):8054. doi: 10.1200/JCO.2022.40.16_suppl.8054
  2. Nisha J, Gupta VA, Hofmeister CC, et al. Efficacy of induction thearapy with lenalidomide, bortezomib, and dexamethasone (RVD) in 1000 newly diagnosed multiple myeloma (MM) patients. Blood. 2018;132(suppl 1):3294. doi:10.1182/blood-2018-99-119895