Lenalidomide-based response-adapted therapy for older adults without high risk myeloma.
lenalidomide
myeloma
older adults
response-adapted therapy
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
03 2019
03 2019
Historique:
received:
01
08
2018
accepted:
15
10
2018
pubmed:
15
12
2018
medline:
31
12
2019
entrez:
15
12
2018
Statut:
ppublish
Résumé
Combined lenalidomide and dexamethasone is a standard-of-care therapy for the treatment of older adults with multiple myeloma. Lenalidomide monotherapy has not been evaluated in newly diagnosed myeloma patients. We conducted a phase II study, evaluating a response-adapted therapy for older adults newly diagnosed with multiple myeloma without high-risk features who were ineligible for high-dose therapy and stem cell transplant. Patients were started on single-agent lenalidomide, and low-dose dexamethasone was added in the event of progressive disease, in a response-adapted approach. The primary endpoint was progression-free survival (PFS), and the International Myeloma Working Group's uniform response criteria were used to assess response and progression. Twenty-seven patients were enrolled, and 20 (74%) experienced a partial response or better to this response-adapted therapy. After a median follow-up of 69 months, the median PFS was 36 months [95% confidence interval (CI), 29·8 to not reached], and the median overall survival was 65 months (95% CI, 35·3 to not reached). Grade 3/4 adverse events were mainly haematological in nature. This response-adapted therapy in this patient population is feasible and results in durable responses that compare favourably with concurrent lenalidomide and dexamethasone. These results should be validated in prospective studies.
Identifiants
pubmed: 30548250
doi: 10.1111/bjh.15700
pmc: PMC7771320
mid: NIHMS1654486
doi:
Substances chimiques
Lenalidomide
F0P408N6V4
Types de publication
Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
735-743Subventions
Organisme : NCI NIH HHS
ID : P30 CA076292
Pays : United States
Informations de copyright
© 2018 British Society for Haematology and John Wiley & Sons Ltd.
Références
Leuk Lymphoma. 2010 Jun;51(6):1015-9
pubmed: 20367570
J Clin Oncol. 2009 Aug 1;27(22):3664-70
pubmed: 19451428
Haematologica. 2009 Feb;94(2):270-5
pubmed: 19144659
Blood. 2010 Aug 5;116(5):679-86
pubmed: 20385792
Blood. 2015 Mar 26;125(13):2068-74
pubmed: 25628469
Blood. 2008 Oct 15;112(8):3107-14
pubmed: 18505783
Blood. 2006 Nov 15;108(10):3458-64
pubmed: 16840727
Blood. 2002 Nov 1;100(9):3063-7
pubmed: 12384400
Eur J Haematol. 2011 Jan;86(1):16-22
pubmed: 20942865
J Clin Oncol. 2009 Jul 20;27(21):3518-25
pubmed: 19528374
Lancet. 2007 Oct 6;370(9594):1209-18
pubmed: 17920916
Lancet Oncol. 2016 Aug;17(8):e328-e346
pubmed: 27511158
Lancet. 2017 Feb 4;389(10068):519-527
pubmed: 28017406
CA Cancer J Clin. 2017 Jan;67(1):7-30
pubmed: 28055103
N Engl J Med. 2014 Sep 4;371(10):906-17
pubmed: 25184863
Br J Haematol. 2018 Jul;182(2):231-244
pubmed: 29938772
N Engl J Med. 2008 Aug 28;359(9):906-17
pubmed: 18753647
Br J Haematol. 2018 Jul;182(2):222-230
pubmed: 29740809
Lancet Oncol. 2010 Jan;11(1):29-37
pubmed: 19853510
Leukemia. 2006 Sep;20(9):1467-73
pubmed: 16855634
Leuk Lymphoma. 2011 Oct;52(10):1942-8
pubmed: 21663513
Blood. 2009 Jul 23;114(4):772-8
pubmed: 19471019
Leuk Lymphoma. 2014 Dec;55(12):2850-7
pubmed: 24588734
Leukemia. 2014 Jun;28(6):1346-8
pubmed: 24418994