Real-world outcomes for the treatment of relapsed/refractory multiple myeloma patients with lenalidomide-dexamethasone combinations in a Latin American country. A retrospective cohort study from grupo argentino de mieloma múltiple

Expert Rev Hematol. 2021 Mar;14(3):315-322. doi: 10.1080/17474086.2021.1886073. Epub 2021 Mar 1.

Abstract

Objectives: We compared the efficacy of lenalidomide-dexamethasone (Rd) based treatments for relapsed/refractory multiple myeloma patients (pts), in a real-world setting. In addition, we evaluated adverse events (AE), progression-free survival (PFS) and overall survival (OS).

Methods: In our retrospective, multicentric study, 156 pts with RRMM were included. 74/156 pts (47%) were refractory to bortezomib (V) and 43/156 (27%) pts to lenalidomide (R), with 24/156 (15%) of pts double refractory. Eighty-six pts (55%) received Rd with carfilzomib (KRd), 30 pts (19%) bortezomib (VRd), 30 pts (19%) daratumumab (DRd), and 10 pts (6%) ixazomib (IRd).

Results: The overall response (ORR) (≥ partial response) for the entire cohort was 71%, with a very good partial response rate or better (≥VGPR) of 35%. We found no significant differences in CR or ≥VGRP rates between treatments (p:0.229). Regardless of the combination received, those patients who achieved CR had significantly improved PFS (p: 0.007). The most frequent cause of treatment discontinuation was disease progression in 55/156 pts (35%). 8 pts (5%) discontinued treatment due to treatment-related adverse events (AE).

Conclusion: This is the first report of Rd combinations for the treatment of RRMM in Latin America. All combinations proved to be effective with an acceptable toxicity.

Keywords: Multiple myeloma; latin America; lenalidomide; real world; relapsed/refractory.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Dexamethasone / therapeutic use
  • Humans
  • Latin America
  • Lenalidomide / therapeutic use
  • Multiple Myeloma* / drug therapy
  • Neoplasm Recurrence, Local / drug therapy
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Dexamethasone
  • Lenalidomide