Lenalidomide Maintenance Beneficial in Multiple Myeloma
(HealthDay News) – For patients with multiple myeloma, maintenance treatment with lenalidomide is associated with improved progression-free survival (PFS) for newly-diagnosed patients ineligible for transplantation and for those who have undergone stem-cell transplantation, according to three Phase 3 studies published in the May 10 issue of the New England Journal of Medicine.
Antonio Palumbo, MD, from the University of Turin in Italy, and colleagues compared melphalan-prednisone-lenalidomide (MPR) induction followed by lenalidomide maintenance (MPR-R; 152 patients) with MPR (153 patients) or melphalan-prednisone (MP; 154 patients) followed by placebo, in patients aged ≥65 years with newly-diagnosed multiple myeloma who were ineligible for transplantation. During a median 30 months of follow-up, the median PFS was significantly longer with MPR-R than with MPR or MP (31 vs. 14 or 13 months; hazard ratio [HR], 0.49 and 0.4, respectively).
In the second study, Philip L. McCarthy, MD, from the Roswell Park Cancer Institute in Buffalo, NY, and colleagues randomly assigned 460 patients with stable disease to lenalidomide or placebo 100 days after undergoing stem-cell transplantation. At a planned interim analysis, progressive disease was seen in 20% of lenalidomide-treated patients, versus 44% of patients receiving placebo. The median time to progression was significantly longer with lenalidomide (46 vs. 27 months). In a third study, Michel Attal, MD, from the Hôpital Purpan in Toulouse, France, and colleagues found that, compared with placebo, lenalidomide maintenance therapy significantly improved PFS (HR, 0.5) and event-free survival in 614 patients with nonprogressive disease after first-line transplantation.
"Lenalidomide maintenance after transplantation significantly prolonged progression-free and event-free survival among patients with multiple myeloma," Attal and colleagues write.
Several authors from the Palumbo study disclosed financial ties to the biopharmaceutical industry, including Celgene, which funded the study. The Attal study was partially funded by Celgene, which provided the study drug and placebo.
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