Lenalidomide plus dexamethasone for patients with relapsed or refractory multiple myeloma: Final results of a non-interventional study and comparison with the pivotal phase 3 clinical trials

Leuk Res. 2018 May:68:90-97. doi: 10.1016/j.leukres.2018.03.008. Epub 2018 Mar 14.

Abstract

Lenalidomide (LEN) is an immunomodulatory drug with significant clinical activity against relapsed and refractory multiple myeloma (r/r MM). Based on the pivotal phase 3 trials MM-009 and MM-010, LEN in combination with dexamethasone (DEX) is approved for treatment of patients with MM who have received at least one prior therapy. LEN monotherapy is also approved in first line treatment. Here, we evaluated LEN/DEX combination therapy in a non-interventional study in patients with r/r MM in routine clinical practice. Patients received LEN/DEX as per Summary of Product Characteristics. Ninety-eight patients were treated with at least 1 cycle of LEN/DEX (median age 71 years; range, 42-88), forty-eight patients with at least 6 cycles. The Kaplan-Meier estimate for overall median time to progression was 12.0 months, 13.9 months for patients receiving second-line therapy and 10.3 months for third-line or higher-line therapy. The overall response rate was 60.2%. The median overall survival was 24.3 months. The most common adverse events were anemia (32.7%), thrombocytopenia (27.6%) and leukopenia (24.5%). Seven (7.1%) patients developed thromboembolic events despite prophylaxis. In conclusion, the combination of LEN/DEX administered to patients with r/r MM in routine clinical practice showed similar effectiveness and safety as demonstrated in the registration trials.

Keywords: Lenalidomide plus dexamethasone; Refractory/relapsed multiple myeloma; Routine clinical practice; Safety; Thromboembolism; Time to progression.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Clinical Trials, Phase III as Topic*
  • Dexamethasone / administration & dosage
  • Dexamethasone / therapeutic use*
  • Disease Progression
  • Febrile Neutropenia / drug therapy
  • Female
  • Humans
  • Infections / drug therapy
  • Kaplan-Meier Estimate
  • Lenalidomide / administration & dosage
  • Lenalidomide / therapeutic use*
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Renal Insufficiency / chemically induced
  • Thrombosis / prevention & control

Substances

  • Dexamethasone
  • Lenalidomide