The first article highlights a celgene sponsored study of continuous lenalidomide treatment in elderly patients newly diagnosed with multiple myeloma. A phase 3 study evaluating the efficacy and safety of lenalidomide combined with melphalan and prednisone in patients. Multiple myeloma had been successfully treated by combining lenalidomide and bortezomib with reports suggesting benefits of such a combination even in relapsedrefractory cases. Lenalidomide maintenance versus observation for patients with. Outcomes in patients with multiple myeloma mm have improved substantially over the past two decades. 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. New england journal of medicine reports on three phase iii. Developments in continuous therapy and maintenance treatment. Melphalan, prednisone, and lenalidomide versus melphalan, prednisone, and thalidomide in untreated multiple myeloma. The therapeutic approach for newly diagnosed multiple myeloma today consists of an induction phase with novel agent com.
Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma article in annals of hematology 995 april 2020 with 8 reads. Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma. Myeloma working group imwg subdivides relapse into dr. The incidence of most adverse events began to reduce after about 18 months of therapy. Updated results of phase iii study evaluating continuous. Continuous lenalidomide treatment for newly diagnosed multiple myeloma new england journal of medicine, 366 2012, pp. Recently, it was demonstrated that ikaros degradation by lenalidomide happens via proteasomedependent pathway and this process is critical for the eradication of myeloma cells.
Treatment of patients with multiple myeloma progressing on frontlinetherapy with lenalidomide skip to main content thank you for visiting. Most patients with newly diagnosed multiple myeloma have achieved. The manageable safety profile of this drug and the encouraging results in subgroup analyses of patients across all cytogenetic. Currently, treatment of newly diagnosed mm ndmm patients is differentiated according to transplanteligibility.
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. Continuous treatment with new agents for newly diagnosed. Continuous lenalidomide treatment for newly diagnosed. Treatment of patients with multiple myeloma progressing on. One of the standards of care in transplantineligible patients is continuous therapy ct with lenalidomide plus lowdose dexamethasone rd until progression facon et al. Palumbo a1, hajek r, delforge m, kropff m, petrucci mt.
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. Multiple myeloma mm is a plasma cells disorder that accounts for approximately % of all hematologic cancers. Revlimid lenalidomide international myeloma foundation. Secondary end points included overall survival os, overall response. Pdf lenalidomide maintenance versus observation for patients. Our aim was to make a comparison of these treatments to rd by a network metaanalysis. 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. 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 and lowdose dexamethasone for the. Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma skip to main content thank you for visiting. Continuous addition of bortezomib to conventional therapy before and after autologous stem cell transplantation prolonged overall survival significantly.
How lenalidomide is changing the treatment of patients with. Lee,2 shangyi huang,3 lugui qiu,4 jejung lee,5 ting liu,6 sungsoo yoon,7 kihyun kim,8 zhi x. Multiple myeloma accounts for around 1% of all cancers worldwide and 1015% of all hematological neoplasms. May 10, 2012 continuous lenalidomide treatment for newly diagnosed multiple myeloma. Continuous lenalidomide deemed a standard of care for newly. Continuous lenalidomide therapy nontransplant eligible population. Mar 09, 2020 lenalidomide len maintenance therapy is the standard of care in newly diagnosed multiple myeloma ndmm following highdose melphalan hdm. Observation following nonimmunomodulatory compound based induction therapy in newly diagnosed multiple myeloma ndmm. Continuous therapy versus fixed duration of therapy in. 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. 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. Lenalidomide in combination with dexamethasone in newly. 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.
Sequential therapy of four cycles of bortezomib, melphalan. The treatment of multiple myeloma changed with thalidomide thalomid, celgene corporation, but its use was limited by toxicity, explained dr richardson. Longterm treatment approaches for patients with newly. Lenalidomide after stemcell transplantation for multiple myeloma. Treatment of patients with newly diagnosed multiple myeloma. In patients with newly diagnosed multiple myeloma, how to maintain the. In conclusion, continuous lenalidomide regimens provide an effective longerterm treatment option in patients with newly diagnosed multiple myeloma ineligible for stemcell transplantation. Revlimid lenalidomide, an immunomodulatory drug imid, is the first oral medication that was developed for treatment of multiple myeloma. The data were presented during the european haematology associations annual congress in barcelona, spain.
Lenalidomide in combination with dexamethasone is effective in relapsed or refractory multiple myeloma 46 and in newly diagnosed multiple myeloma. Multiple myeloma mm accounts for 1% of all cancers and. Because maintenance treatment is administered as continuous. 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. Continuous lenalidomide treatment after bortezomib. Continuous treatment with lenalidomide and lowdose dexamethasone in transplantineligible patients with newly diagnosed multiple myeloma in asia. 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. Lenalidomide maintenance after autologous stemcell transplantation in newly diagnosed multiple myeloma. Developments in continuous therapy and maintenance. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. Melphalan, prednisone, and lenalidomide treatment for newly diagnosed myeloma.
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. Lenalidomide has significant activity in the setting of multiple myeloma. Background lenalidomide has tumoricidal and immunomodulatory activity against multiple myeloma. Continuous lenalidomide treatment for newly diagnosed multiple. Continuous treatment had typically been reserved for patients who relapsed following 72. Pdf continuous lenalidomide treatment for newly diagnosed.
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. Continuous therapy with lenalidomide in multiple myeloma. Most patients with newly diagnosed multiple myeloma. 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. Update on the initial therapy of multiple myeloma ariez publishing.
Gmmgmm5 responseadapted lenalidomide maintenance in newly. Original article from the new england journal of medicine continuous lenalidomide treatment for newly diagnosed multiple myeloma. Lenalidomide as maintenance for every newly diagnosed patient. It is used in the newly diagnosed, maintenance therapy, and relapsed andor refractory settings.
Ask dr durie everything you need to know about continuous. Continuous therapy with lenalidomide in multiple myeloma by nizar bahlis, md. 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. Triplet vs doublet lenalidomidecontaining regimens for the. Continuous lenalidomide and lowdose dexamethasone for the treatment of patients with newly diagnosed multiple myeloma and renal impairment in the first trial author m. Continuous therapy in standard and highrisk newlydiagnosed. What are neurologic symptoms in multiple myeloma mm. Mprr significantly prolonged progressionfree survival in patients with newly di agnosed multiple myeloma who were ineligible for. Lenalidomide maintenance versus observation for patients. Mar 03, 2016 multiple myeloma mm is the second most frequent hematologic cancer, with a median age at diagnosis of. Continuous lenalidomide treatment after bortezomibmelphalan. Treatment outcomes in patients with newly diagnosed multiple. Currently lenalidomide plus dexamethasone rd is one of the standard treatments.
The primary end point was progressionfree survival pfs. Mar 26, 2020 continuous lenalidomide treatment for newly diagnosed multiple myeloma. Continuous therapy with novel agents consistently improved progressionfree survival pfs compared with. Continuous lenalidomide deemed a standard of care for newly diagnosed multiple myeloma. Continuous lenalidomide treatment for newly diagnosed multiple myeloma mm015 this doubleblind, phase iii, multicenter. Lenalidomide now for newly diagnosed multiple myeloma patients.