Lenalidomide and low-dose dexamethasone (Rd) are a standard treatment for older adults with multiple myeloma (MM). Lenalidomide monotherapy has rarely been evaluated for newly diagnosed transplant-ineligible MM patients. This multicenter phase II trial evaluated a response-adapted strategy for elderly patients with newly diagnosed MM without high-risk features. Patients were administered single-agent lenalidomide for the first 21 days of two 28-day cycles. Patients with progressive disease received Rd. The primary endpoint was progression-free survival using the uniform response assessment from the International Myeloma Working Group. Of the 34 enrolled patients, 28 were included in the efficacy analysis. The overall response rate (ORR, ≥ partial response [PR]) to single-agent lenalidomide or lenalidomide plus prednisone was 64.3%. Ten patients received Rd after disease progression, with an Rd ORR of 70%. The ORR of response-adapted lenalidomide-based therapy was 75%. After the median follow-up of 35.6 months, the median progression-free survival was 33.5 months (95% confidence interval [CI], 16.9-50.2), and the median overall survival was 51.8 months (95% CI, 22.0-81.6). The most common adverse event was neutropenia (46.7%), and 17 patients (56.7%) experienced infection including pneumonia. Response-adapted lenalidomide-based therapy was feasible in newly diagnosed, transplant-ineligible MM patients without high-risk features.
|Journal||Current Problems in Cancer|
|Publication status||Published - 2022 Feb|
Bibliographical noteFunding Information:
This work was supported by Celgene Corporation [Grant RV-MM-PI-0567].
RB received research funding from Celgene, Karyopharm, Abbvie, Merck, and Sanofi; is on the advisory boards of Celgene, Karyopharm, and Sanofi; and has received honoraria from GSK. The other authors declare that they have no conflict of interest.
This research was conducted under the auspices of the Korean Society of Hematology Multiple Myeloma Working Party (KMMWP). We thank the centers that participated in this study.
All Science Journal Classification (ASJC) codes
- Cancer Research