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Prolonged treatment with lenalidomide in relapsed and refractory multiple myeloma

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Abstract

The medical treatment of multiple myeloma has significantly improved over the last few years. Lenalidomide is an immunomodulatory agent approved, in combination with dexamethasone, to treat this disease. The agent is well tolerated and results in disease improvement in 60% of treated patients. The overall outcome of patients who achieve a response is better than those who do not. However, attaining a response can take several months. Prolonged treatment has been associated with induction of responses of better quality and maintenance of responses, leading to better long-term outcomes. The clinical cases presented here illustrate how continued long-term administration of lenalidomide in combination with dexamethasone: 1) is effective for patients who are resistant to thalidomide, regardless of the type of prior therapy; 2) is suitable for patients with neuropathy and renal impairment: and finally 3) leads to a long lasting, clinically meaningful outcome when treatment is adapted to the best tolerated dose.

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References

  1. Kyle RA, Rajkumar SV. Multiple myeloma. N Engl J Med. 2004;351:1860–1873.

    Article  PubMed  CAS  Google Scholar 

  2. Kristinsson SY, Landgren O, Dickman PW, Derolf AR, Bjorkholm M. Patterns of survival in multiple myeloma: a population-based study of patients diagnosed in Sweden from 1973 to 2003. J Clin Oncol. 2007;25:1993–1999.

    Article  PubMed  Google Scholar 

  3. Kumar SK, Rajkumar SV, Dispenzieri A, et al. Improved survival in multiple myeloma and the impact of novel therapies. Blood. 2008;111:2516–2520.

    Article  PubMed  CAS  Google Scholar 

  4. Quach H, Ritchie D, Stewart AK, et al. Mechanism of action of immunomodulatory drugs (IMiDS) in multiple myeloma. Leukemia. 2010;24:22–32.

    Article  PubMed  CAS  Google Scholar 

  5. Dimopoulos M, Spencer A, Attal M, et al. Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma. N Engl J Med. 2007;357:2123–2132.

    Article  PubMed  CAS  Google Scholar 

  6. Weber DM, Chen C, Niesvizky R, et al. Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America. N Engl J Med. 2007;357:2133–2142.

    Article  PubMed  CAS  Google Scholar 

  7. Attal M, Cances-Lauwers V, Marit G, et al. Maintenance treatment with lenalidomide after transplantation for MYELOMA: Final analysis of the IFM 2005-02. Blood. 2010;116:Abstract 310 and oral presentation at: American Society of Hematology Annual Meeting; December 4–7, 2010; Orlando, FL.

  8. McCarthy PL, Owzar K, Anderson KC, et al. Phase III intergroup study of lenalidomide versus placebo maintenance therapy following single autologous hematopoietic stem cell transplantation (AHSCT) for multiple myeloma: CALGB 100104. Blood. 2010;116:Abstract 37 and oral presentation at: American Society of Hematology Annual Meeting; December 4–7, 2010; Orlando, FL.

  9. Palumbo A, Delforge M, Catalano J, et al. A phase 3 study evaluating the efficacy and safety of lenalidomide combined with melphalan and prednisone in patients >65 years with newly diagnosed multiple myeloma (NDMM): Continuous use of lenalidomide vs fixed-duration regimens. Blood. 2010;116:Abstract 622 and oral presentation at: American Society of Hematology Annual Meeting; December 4–7, 2010; Orlando, FL.

  10. Attal M, Harousseau JL, Stoppa AM, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Français du Myélome. N Engl J Med. 1996;335:91–97.

    Article  PubMed  CAS  Google Scholar 

  11. Harousseau J, Avet-Loiseau H, Attal M, et al. Achievement of at least very good partial response is a simple and robust prognostic factor in patients with multiple myeloma treated with high-dose therapy: long-term analysis of the IFM 99-02 and 99-04 trials. J Clin Oncol. 2009;27:5720–5726.

    Article  PubMed  CAS  Google Scholar 

  12. Lahuerta JJ, Mateos MV, Martínez-López J, et al. Influence of pre- and post-transplantation responses on outcome of patients with multiple myeloma: sequential improvement of response and achievement of complete response are associated with longer survival. J Clin Oncol. 2008;26:5775–5782.

    Article  PubMed  Google Scholar 

  13. Dimopoulos MA, Chen C, Spencer A, et al. Long-term follow-up on overall survival from the MM-009 and MM-010 phase III trials of lenalidomide plus dexamethasone in patients with relapsed or refractory multiple myeloma. Leukemia. 2009;23:2147–2152.

    Article  PubMed  CAS  Google Scholar 

  14. Harousseau J, Dimopoulos MA, Wang M, et al. Better quality of response to lenalidomide plus dexamethasone is associated with improved clinical outcomes in patients with relapsed or refractory multiple myeloma. Haematologica. 2010;95:1738–1744.

    Article  PubMed  Google Scholar 

  15. Dimopoulos M, Alegre A, Stadtmauer E, et al. The efficacy and safety of lenalidomide plus dexamethasone in relapsed and/or refractory multiple myeloma patients with impaired renal function. Cancer. 2010;116:3807–3814.

    Article  PubMed  CAS  Google Scholar 

  16. San-Miguel JF, Dimopoulos MA, Stadtmauer EA, et al. Effects of lenalidomide and dexamethasone treatment duration on survival in patients with relapsed or refractory multiple myeloma treated with lenalidomide and dexamethasone. Clin Lymphoma Myeloma Leuk. 2011;11:38–43.

    PubMed  CAS  Google Scholar 

  17. Dimopoulos MA, Hussein M, Swern AS, Weber D. Full dose of lenalidomide for 12 months followed by a lower maintenance dose improves progression-free survival in patients with relapsed/refractory multiple myeloma. ASH Annual Meeting Abstracts. 2009;114:2874.

    Google Scholar 

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Authors and Affiliations

  1. Hematology Department, Hospital General Santa Bárbara, Soria, Spain

    Carlos Aguilar Franco

  2. Hematology Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain

    Luis Palomera

  3. Hematology Department, Hospital de Antequera, ASNM, Antequera, Málaga, Spain

    Jose Joaquín Ruiz Arredondo

  4. Department of Hematology, Hospital Universitario Virgen del Rocío, Sevilla, Avenida Manuel Siurot s/n, 41013, Sevilla, Spain

    Jesús Martín Sánchez

Authors
  1. Carlos Aguilar Franco
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  2. Luis Palomera
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  3. Jose Joaquín Ruiz Arredondo
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  4. Jesús Martín Sánchez
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Correspondence to Jesús Martín Sánchez.

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Franco, C.A., Palomera, L., Arredondo, J.J.R. et al. Prolonged treatment with lenalidomide in relapsed and refractory multiple myeloma. Adv Therapy 28 (Suppl 8), 14–19 (2011). https://doi.org/10.1007/s12325-011-0081-6

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  • DOI: https://doi.org/10.1007/s12325-011-0081-6

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