Lenalidomide and Dexamethasone in Transplant-Ineligible Patients with Myeloma

• Published in: The New England journal of medicine Vol. 371; no. 10; pp. 906 - 917
• Main Authors: Benboubker, Lotfi, Dimopoulos, Meletios A, Dispenzieri, Angela, Catalano, John, Belch, Andrew R, Cavo, Michele, Pinto, Antonello, Weisel, Katja, Ludwig, Heinz, Bahlis, Nizar, Banos, Anne, Tiab, Mourad, Delforge, Michel, Cavenagh, Jamie, Geraldes, Catarina, Lee, Je-Jung, Chen, Christine, Oriol, Albert, de la Rubia, Javier, Qiu, Lugui, White, Darrell J, Binder, Daniel, Anderson, Kenneth, Fermand, Jean-Paul, Moreau, Philippe, Attal, Michel, Knight, Robert, Chen, Guang, Van Oostendorp, Jason, Jacques, Christian, Ervin-Haynes, Annette, Avet-Loiseau, Hervé, Hulin, Cyrille, Facon, Thierry
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 04.09.2014
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; Chemotherapy; Clinical trials; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - adverse effects; Disease-Free Survival; Drug dosages; Female; General aspects; Humans; Immunodeficiencies. Immunoglobulinopathies; Immunoglobulinopathies; Immunomodulators; Immunopathology; Immunotherapy; Kaplan-Meier Estimate; Male; Medical research; Medical sciences; Melphalan; Melphalan - administration & dosage; Middle Aged; Multiple myeloma; Multiple Myeloma - drug therapy; Multiple Myeloma - immunology; Pharmacology. Drug treatments; Prednisone; Prednisone - administration & dosage; Stem cell transplantation; Steroids; Targeted cancer therapy; Thalidomide; Thalidomide - administration & dosage; Thalidomide - adverse effects; Thalidomide - analogs & derivatives; Transplants & implants; Antineoplastic agent; Human; Corticosteroid; Immunopathology; Dexamethasone; Lenalidomide; Steroid hormone; Antiinflammatory agent; Malignant hemopathy; Myeloma; Immunomodulator; Medicine; Immunoglobulinopathy; Lymphoproliferative syndrome; Cancer
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1402551

In patients ineligible for transplantation, the combination of lenalidomide and dexamethasone with lenalidomide maintenance until disease progression achieved significantly improved progression-free survival, as compared with melphalan, prednisone, and thalidomide therapy. For patients with newly diagnosed multiple myeloma who are ineligible for autologous stem-cell transplantation, the standard therapy is melphalan and prednisone (MP) combined with either thalidomide (MPT) or bortezomib (VMP). 1 – 10 Lenalidomide (Revlimid, Celgene) is an immunomodulatory drug that, in combination with dexamethasone, is a standard treatment option for patients with multiple myeloma who have received at least one prior therapy as approved by the Food and Drug Administration and the European Medicines Agency. 7 – 13 In a randomized trial that included both younger and older patients with newly diagnosed multiple myeloma, lenalidomide plus low-dose dexamethasone was associated with fewer adverse . . .