Lenalidomide-based response-adapted therapy for older adults without high risk myeloma
- Authors
- Baz, Rachid; Mahrukh, Syeda; Naqvi, Hussnain; Lee, Jae-Hoon; Brayer, Jason; Hillgruber, Nancy; Fridley, Brooke L.; Shain, Kenneth H.; Sullivan, Daniel M.; Alsina, Melissa
- Issue Date
- Mar-2019
- Publisher
- WILEY
- Keywords
- myeloma; lenalidomide; older adults; response-adapted therapy
- Citation
- BRITISH JOURNAL OF HAEMATOLOGY, v.184, no.5, pp.735 - 743
- Journal Title
- BRITISH JOURNAL OF HAEMATOLOGY
- Volume
- 184
- Number
- 5
- Start Page
- 735
- End Page
- 743
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/1762
- DOI
- 10.1111/bjh.15700
- ISSN
- 0007-1048
- Abstract
- 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 center dot 8 to not reached], and the median overall survival was 65 months (95% CI, 35 center dot 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.
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