Pdf lenalidomide maintenance versus observation for patients. Treatment of patients with newly diagnosed multiple myeloma. Continuous treatment with lenalidomide and lowdose dexamethasone in transplantineligible patients with newly diagnosed multiple myeloma in asia. Continuous lenalidomide treatment after bortezomib.
Almost all patients with mm evolve from an asymptomatic premalignant stage termed monoclonal gammopathy of undetermined significance mgus. On february 18, 2015, the indication for lenalidomide revlimid in combination with dexamethasone was expanded to include patients with newly diagnosed multiple myeloma. Melphalan, prednisone, and lenalidomide treatment for newly diagnosed myeloma. Melphalan, prednisone, and lenalidomide versus melphalan, prednisone, and thalidomide in untreated multiple myeloma. Continuous therapy in standard and highrisk newlydiagnosed. Currently lenalidomide plus dexamethasone rd is one of the standard treatments. It is used in the newly diagnosed, maintenance therapy, and relapsed andor refractory settings. In germany there are around 6500 new cases of multiple myeloma each year and it is the third most commonly occurring disease of the blood after leukemia and nonhodgkin lymphoma. Original article from the new england journal of medicine continuous lenalidomide treatment for newly diagnosed multiple myeloma. Many new regimens have been applied to newly diagnosed transplantineligible multiple myeloma, but no headtohead research has been performed to compare the efficacy of these treatments. Continuous lenalidomide deemed a standard of care for newly diagnosed multiple myeloma.
One of the standards of care in transplantineligible patients is continuous therapy ct with lenalidomide plus lowdose dexamethasone rd until progression facon et al. Lenalidomide maintenance versus observation for patients. Lenalidomide maintenance after autologous stemcell transplantation in newly diagnosed multiple myeloma. Continuous lenalidomide therapy nontransplant eligible population. Most patients with newly diagnosed multiple myeloma have achieved. Lenalidomide as maintenance for every newly diagnosed patient.
Most patients with newly diagnosed multiple myeloma. Mprr significantly prolonged progressionfree survival in patients with newly di agnosed multiple myeloma who were ineligible for. In conclusion, continuous lenalidomide regimens provide an effective longerterm treatment option in patients with newly diagnosed multiple myeloma ineligible for stemcell transplantation. In patients with newly diagnosed multiple myeloma, how to maintain the. Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma.
Continuous lenalidomide treatment for newly diagnosed multiple myeloma. Continuous lenalidomide treatment after bortezomibmelphalan. To make the most of these two strategies, we investigated the efficacy and feasibility of firstline treatment with 4 cycles of vmp followed by continuous rd therapy in a multi. Our aim was to make a comparison of these treatments to rd by a network metaanalysis. A phase 3 study evaluating the efficacy and safety of lenalidomide combined with melphalan and prednisone in patients. What are neurologic symptoms in multiple myeloma mm.
These are the results of phase ii study of bortezomibmelphalanprednisolone vmp induction therapy followed by lenalidomide dexamethasone rd consolidation and lenalidomide maintenance in transplantineligible patients with newly diagnosed multiple myeloma ndmm. Mm027 trial background nonimmunomodulatory induction therapy tx is associated with high response rates and is recommended by the current nccn guidelines for mm frontline tx1. Mar 09, 2020 lenalidomide len maintenance therapy is the standard of care in newly diagnosed multiple myeloma ndmm following highdose melphalan hdm. Nov 25, 2019 the combinations of melphalan, bortezomib, and prednisolone vmp and of lenalidomide and dexamethasone rd are standard treatment strategies for transplantineligible newly diagnosed multiple myeloma ndmm. Continuous treatment with new agents for newly diagnosed. Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma skip to main content thank you for visiting. Lenalidomide maintenance versus observation for patients with. Initial phase iii study of lenalidomide in relapsed myeloma determined the ideal dose to be 25 mg once daily given for 3 of 4 weeks. Update on the initial therapy of multiple myeloma ariez publishing.
Updated results of phase iii study evaluating continuous. Developments in continuous therapy and maintenance. These are the results of phase ii study of bortezomibmelphalanprednisolone vmp induction therapy followed by lenalidomidedexamethasone rd consolidation and lenalidomide maintenance in transplantineligible patients with newly diagnosed multiple myeloma ndmm. Palumbo a1, hajek r, delforge m, kropff m, petrucci mt. Lenalidomide in combination with dexamethasone is effective in relapsed or refractory multiple myeloma 46 and in newly diagnosed multiple myeloma. The therapeutic approach for newly diagnosed multiple myeloma today consists of an induction phase with novel agent com. Background lenalidomide has tumoricidal and immunomodulatory activity against multiple myeloma. Continuous therapy with lenalidomide in multiple myeloma.
Outcomes in patients with multiple myeloma mm have improved substantially over the past two decades. Continuous therapy with novel agents consistently improved progressionfree survival pfs compared with. Lenalidomide in combination with dexamethasone in newly. Ask dr durie everything you need to know about continuous. Sequential therapy of four cycles of bortezomib, melphalan. Lenalidomide has significant activity in the setting of multiple myeloma. Continuous lenalidomide treatment for newly diagnosed multiple. Continuous treatment had typically been reserved for patients who relapsed following 72. The manageable safety profile of this drug and the encouraging results in subgroup analyses of patients across all cytogenetic. Multiple agents have been and are being investigated as longterm options in the treatment of newly diagnosed mm ndmm, including the immunomodulatory drugs lenalidomide and thalidomide, the. Treatment of patients with multiple myeloma progressing on frontlinetherapy with lenalidomide skip to main content thank you for visiting. Lenalidomide now for newly diagnosed multiple myeloma patients. Dec 14, 2018 in patients with newly diagnosed multiple myeloma, how to maintain the responses achieved after optimal therapeutic strategies was a challenge, and maintenance therapy emerged as an option aiming to extend the duration of the response through continued treatment and thereby improving progressionfree survival and overall survival. How lenalidomide is changing the treatment of patients with.
Lenalidomide after stemcell transplantation for multiple myeloma. Continuous therapy with lenalidomide in multiple myeloma by nizar bahlis, md. Recently, it was demonstrated that ikaros degradation by lenalidomide happens via proteasomedependent pathway and this process is critical for the eradication of myeloma cells. Continuous lenalidomide treatment for newly diagnosed multiple myeloma new england journal of medicine, 366 2012, pp. Pdf continuous lenalidomide treatment for newly diagnosed.
Continuous lenalidomide deemed a standard of care for newly. Because maintenance treatment is administered as continuous. Continuous therapy versus fixed duration of therapy in. Gmmgmm5 responseadapted lenalidomide maintenance in newly.
Continuous addition of bortezomib to conventional therapy before and after autologous stem cell transplantation prolonged overall survival significantly. Multiple myeloma had been successfully treated by combining lenalidomide and bortezomib with reports suggesting benefits of such a combination even in relapsedrefractory cases. Continuous lenalidomide and lowdose dexamethasone for the. Mar 20, 2019 the treatment of multiple myeloma mm has changed dramatically in the past decade with the introduction of new drugs into therapeutic strategies, both in the frontline and in the relapse settings. Maintenance therapy with lenalidomide significantly improved progressionfree survival in patients with newly diagnosed multiple myeloma compared with observation, but did not improve overall survival in the intentiontotreat analysis of the whole trial population. Continuous lenalidomide treatment for newly diagnosed. Triplet vs doublet lenalidomidecontaining regimens for the. Revlimid lenalidomide international myeloma foundation. Treatment outcomes in patients with newly diagnosed multiple. Continuous lenalidomide treatment for newly diagnosed multiple myeloma mm015 this doubleblind, phase iii, multicenter. The first article highlights a celgene sponsored study of continuous lenalidomide treatment in elderly patients newly diagnosed with multiple myeloma. Revlimid lenalidomide, an immunomodulatory drug imid, is the first oral medication that was developed for treatment of multiple myeloma.
Secondary end points included overall survival os, overall response. May 10, 2012 continuous lenalidomide treatment for newly diagnosed multiple myeloma. The data were presented during the european haematology associations annual congress in barcelona, spain. Multiple myeloma mm accounts for 1% of all cancers and.
Treatment of patients with multiple myeloma progressing on. Myeloma working group imwg subdivides relapse into dr. The primary end point was progressionfree survival pfs. The treatment of multiple myeloma changed with thalidomide thalomid, celgene corporation, but its use was limited by toxicity, explained dr richardson. Continuous lenalidomide plus lowdose dexamethasone, compared with melphalan, prednisolone plus thalidomide, significantly improved progressionfree survival in treatment naive patients with newly diagnosed multiple myeloma who were not eligible for transplant. Longterm treatment approaches for patients with newly. The incidence of most adverse events began to reduce after about 18 months of therapy. Continuous lenalidomide and lowdose dexamethasone for the treatment of patients with newly diagnosed multiple myeloma and renal impairment in the first trial author m. Mar 26, 2020 continuous lenalidomide treatment for newly diagnosed multiple myeloma. Observation following nonimmunomodulatory compound based induction therapy in newly diagnosed multiple myeloma ndmm. Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma article in annals of hematology 995 april 2020 with 8 reads. Developments in continuous therapy and maintenance treatment.