Lenalidomide-based response-adapted therapy for older adults without high risk myeloma.

Lenalidomide-based response-adapted therapy for older adults without high risk myeloma.

Br J Haematol. 2018 Dec 12;:

Authors: Baz R, Naqvi SMH, Lee JH, Brayer J, Hillgruber N, Fridley BL, Shain KH, Sullivan DM, Alsina M

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), 29·8 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.

PMID: 30548250 [PubMed - as supplied by publisher]

from PubMed via alexandrossfakianakis on Inoreader https://ift.tt/2CfgS02