Lenalidomide for relapsed or refractory multiple myeloma
https://doi.org/10.17650/1818-8346-2012-7-1-6-14
Abstract
We report the activity of lenalidomide (revlimide – R), lenalidomide plus dexamethasone (Rd), lenalidomide plus bortezomib plus dexamethasone (RVd) in 34 patients with relapsed and refractory myeloma. For patients who received lenalidomide the overall response rate was 70.5 %. 38 % patients achieved very good partial response (VGPR) + complete response (CR). Median overall survival (OS) was 48 months. Lenalidomide may overcome the poor prognostic impact of various factors, particularly elevated beta (2)-microglobulin. Lenalidomide is highly active in elderly patients (> 65 years). Significantly increased OS with a lenalidomide-based induction and lenalidomide maintenance therapy was revealed. The median duration of the overall response without lenalidomide maintenance therapy was 10 months. The median duration of the overall response with lenalidomide maintenance therapy was 20 months (р < 0,05). Median OS with lenalidomide maintenance therapy was not reached. Median OS without lenalidomide maintenance therapy was 36 months (р < 0.05). Side effects were predictable and manageable. The most common adverse events reported were neutropenia (38.3 %) and thrombocytopenia (23.7 %). Serious adverse events were rare.
About the Authors
S. S. Bessmeltsev1Russian Federation
E. V. Kariagina
Russian Federation
L. V. Stelmashenko
Russian Federation
G. N. Salogub
Russian Federation
E. R. Machulaitene
Russian Federation
K. M. Abdulkadyrov
Russian Federation
N. A. Kotova
Russian Federation
I. I. Kostroma
Russian Federation
N. V. Medvedeva
Russian Federation
L. I. Krylova
Russian Federation
E. Yu. Ilushkina
Russian Federation
References
1. Бессмельцев С.С. Новые противоопухолевые препараты в лечении множественной миеломы. Вестн гематол 2006;2(2):27–41.
2. Weber D., Knight R., Chen C. et al. Prolonged overall survival with lenalidomide plus dexamethasone compared with dexamethasone alone in patients with relapsed or refractory multiple myeloma.
3. Blood 2007;110:abstr. 412.
4. Dimopoulos M., Spencer A., Attal M. et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med 2007;357:2123–32.
5. Richardson P.G., Weller E., Jagannath S. et al. Multicenter, phase I, dose-escalation trial of lenalidomide plus bortezomib for relapsed and relapsed/refractory multiple myeloma. J Clin Oncol 2009;27(34):5713–9.
6. Rajkumar S.V., Hayman S.R., Lacy M.Q. et al. Combination therapy with lenalidomideplus dexamethasone for newly diagnosed myeloma. Blood 2005;106:4050–3.
7. Kumar S.K., Lacy M.Q., Hayman S.R. et al. Lenalidomide, cyclophosphamide and dexamethasone (CRd) for newly diagnosed multiple myeloma: Results from a phase 2 trial. Am J Hematol 2011 Apr 18. doi:
8. 1002/ajh.22053.
9. Palumbo A., Dimopoulos M.A., Delforge M. et al. A phase III study to determine the efficacy and safety of lenalidomide in combination with melphalan and prednisone (MPR) in elderly patients with
10. newly diagnosed multiple myeloma. Blood 2009;114:253 (abstr. 613).
11. Blade J., Samson D., Reece D. et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Br J Haematol 1998;102:1115–23.
12. Rajkumar S.V., Harousseau J.-L., Durie B. et al. Consensus recommendations for the uniform reporting of clinical trials: report of the International Myeloma Workshop Consensus Panel 1. Blood.
13. Prepublished online Feb 3, 2011. doi:10.1182/blood-2010-10-299487.
14. Бессмельцев С.С., Абдулкадыров К.М. Множественная миелома. Современный взгляд на проблему. Алматы, 2007. 480 с.
15. Kurabayashi H., Kubota K., Tsuchiya J. et al. Prognostic value of morphological classifications and clinical variables in elderly and young patients with multiple myeloma. Ann Hematol 1999;78:19–23.
16. Rajkumar S.V., Jacobus S., Callander N.S. et al. Lenalidomide plus high-dose dexamethasone versus lenalidomide plus low-dose dexamethasone as initial therapy for newly diagnosed multiple myeloma:
17. an open-label randomised controlled trial. Lancet Oncol 2010;11:29–37.
18. Zonder A.J., Crowley J., Hussein M.A. et al. Lenalidomide and high-dose dexamethasone compared with dexamethasone as initial therapy for multiple myeloma: a randomized Southwest Oncology
19. Group trial. Blood 2010;116:5838–41.
20. Palumbo A., Rajkumar S.V., Dimopoulos M.A. et al. Prevention of thalidomide- and lenalidomide-associated thrombosis in myeloma. Leukemia 2008;22:414–23.
Review
For citations:
Bessmeltsev1 S.S., Kariagina E.V., Stelmashenko L.V., Salogub G.N., Machulaitene E.R., Abdulkadyrov K.M., Kotova N.A., Kostroma I.I., Medvedeva N.V., Krylova L.I., Ilushkina E.Yu. Lenalidomide for relapsed or refractory multiple myeloma. Oncohematology. 2012;7(1):6-14. (In Russ.) https://doi.org/10.17650/1818-8346-2012-7-1-6-14