Lenalidomide in relapsed and refractory multiple myeloma disease: feasibility and benefits of long-term treatment

2014 ◽  
Vol 93 (12) ◽  
pp. 1993-1999 ◽  
Author(s):  
Manola Zago ◽  
Katharina Oehrlein ◽  
Corinna Rendl ◽  
Corinna Hahn-Ast ◽  
Lothar Kanz ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Term Treatment ◽  
Refractory Multiple Myeloma ◽  
Long Term Treatment

Lenalidomide in Relapsed and Refractory Multiple Myeloma Disease: Feasibility and Benefits of Long-Term Treatment

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 4069-4069 ◽  
Author(s):  
Katharina Oehrlein ◽  
Corinna Rendl ◽  
Corinna Hahn-Ast ◽  
Lothar Kanz ◽  
Katja C Weisel
Keyword(s):  
Multiple Myeloma ◽  
High Risk ◽  
Median Time ◽  
Allogeneic Transplantation ◽  
Term Treatment ◽  
Study Patient ◽  
Refractory Multiple Myeloma ◽  
Long Term Treatment ◽  
Unacceptable Toxicity

Abstract Abstract 4069 Despite the progress obtained by the introduction of novel agents, treatment of relapsed/refractory multiple myeloma (rrMM) remains a clinical challenge. Long-term treatment aims to delay progression of MM, but there is concern regarding tolerance, especially in the non-study patient (pt) population. The mode of action of Lenalidomide (len) as an immunomodulatory agent and the tolerability profile led to approval of the drug for continuous treatment until disease progression (PD) or unacceptable toxicity. Due to the lack/scarcity of reports assessing benefit and risk of long-term len treatment in non-selected rrMM patients, we retrospectively analysed the long-term outcome in pts with rrMM treated with len/dex. 67 pts who were treated with len/dex for rrMM in the approved indication until PD or unacceptable toxicity from 2007 to 2011 were included in this retrospective, single-centre analysis. Median age was 68 years (y) (range 40–84y), median number of pretreatments were 2 (range 1–6). 31 pts (46%) had relapsed after autologous stem cell transplant, 10 pts (15%) after allogeneic transplantation. 40 pts (60%) received prior treatment with bortezomib, 13 (19%) with thalidomide-containing regimen. Cytogenetic analysis was available in 28 pts (41.8%), 8 pts had cytogenetic high-risk disease defined as presence of t(4;14), del17 or +1q21 in FISH analysis. Overall response rate (ORR) under len/dex was 82.1% comprising 41 pts (61.2%) with PR, 9 pts (13.4%) with VGPR and 5 pts (7.5%) with CR. Median time to best response was 5.5 months (mo)., median time to documented CR 36.6 mo. Median treatment duration with len was 16.1 mo (range 0.7–47.4 mo). 45 pts (67.2%) were treated with len/dex >12 mo, 25 (37.3%) >24 mo, 9 (13.4%) >36 mo and 14 pts were still on treatment at the time of analysis. Of the 45 pts with len treatment >12 mo 21 pts underwent prior autologous transplant, and 7 pts allogeneic transplantation. 4/8 pts with high-risk cytogenetics were treated with len >12 mo. Among the 22 pts with len <12 mo, 12 pt discontinued treatment due to PD, in 8 pts treatment was stopped due to toxicity or patient's wish; 2 pts proceeded to allogenic transplantation. Reasons for treatment discontinuation other than PD were fatigue, subjective intolerance and, in one pt, a thrombembolic event. In pts >12 mo on len, documented main toxicities were hematologic with grade III/IV toxicity in 17 pts (37.8%). Median overall survival (OS) of the total pt population was 33.2 mo, whereas OS of pts discontinuing len before 12 mo was 14.4 mo (20.5 mo for pts stopping for other reasons than PD; p=0.0003), pts treated beyond 12 mo had a median OS of 42.9 mo (p<0.0001). OS of pt >12 mo on len treatment did not significantly differ between pts that had received autologous transplantation, allogeneic transplantation or conventional therapy (43.1 mo, 48.0 mo, 36.8 mo, respectively). To the best of our knowledge, this is the first report on feasibility and efficacy of long-term len treatment in a non-selected pt cohort with rrMM. We thereby provide evidence that len is an efficient and safe long-term treatment option providing clinical benefit for the majority of patients. Outcome of pt >12 mo on len is superior when compared to pt discontinued earlier for reasons other than PD. Furthermore, the favourable outcome of pts treated for more than 12 mo was independent of previous autologous and allogeneic transplantation. Our data confirm the current use of len as a continuous long-term treatment strategy. Disclosures: Weisel: Celgene: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding.

scholarly journals Efficacy and safety of long-term treatment with lenalidomide and dexamethasone in patients with relapsed/refractory multiple myeloma

2014 ◽  
Vol 4 (11) ◽  
pp. e257-e257 ◽  
Author(s):  
M A Dimopoulos ◽  
A S Swern ◽  
J S Li ◽  
M Hussein ◽  
L Weiss ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Term Treatment ◽  
Efficacy And Safety ◽  
Refractory Multiple Myeloma ◽  
Long Term Treatment

scholarly journals Efficacy of Long-Term Treatment with Low-Dose Thalidomide for Patients with Relapsed/Refractory Multiple Myeloma

2011 ◽  
Vol 02 (05) ◽  
pp. 570-575
Author(s):  
Kazuyuki Shimizu ◽  
Hirokazu Murakami ◽  
Morio Sawamura ◽  
Yutaka Hattori ◽  
Shin-ichiro Okamoto ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Term Treatment ◽  
Refractory Multiple Myeloma ◽  
Long Term Treatment

First-line, long-term treatment of multiple myeloma with thalidomide, dexamethasone, and zoledronate in combination (TDZ)

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 6702-6702
Author(s):  
U. Klueppelberg ◽  
L. Chen ◽  
C. M. Aloba ◽  
J. Shapira ◽  
E. Smith ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Term Treatment ◽  
First Line ◽  
Long Term Treatment

scholarly journals Long-Term Disease Control by Pomalidomide-/Dexamethasone-Based Therapy in a Patient with Advanced Multiple Myeloma: A Case Report and Review of the Literature

2015 ◽  
Vol 8 (1) ◽  
pp. 189-195 ◽  
Author(s):  
Sophia Danhof ◽  
Martin Schreder ◽  
Susanne Strifler ◽  
Hermann Einsele ◽  
Stefan Knop
Keyword(s):  
Multiple Myeloma ◽  
Case Report ◽  
Proteasome Inhibitors ◽  
Progression Free Survival ◽  
Infectious Complications ◽  
Term Treatment ◽  
Novel Agents ◽  
Virus Reactivation ◽  
Long Term Treatment

Background: Therapy for multiple myeloma (MM) has substantially improved in the era of immunomodulatory drugs and bortezomib. However, the prognosis of patients with progressive disease despite treatment with these ‘novel agents' remains poor. Recently, pomalidomide was approved in this setting, but a median progression-free survival of <4 months still leaves room for improvement. Pomalidomide-based combination therapies are currently under investigation, but data on long-term treatment are lacking. Case Report: We present the case of a 68-year-old woman with refractory MM who received pomalidomide in combination with various drugs including anthracyclines, alkylators and proteasome inhibitors. Initially, major hematological toxicities and infectious complications including a hepatitis B virus reactivation were encountered. With careful dose adjustments and selection of combination partners, pomalidomide treatment was maintained for over 4 years and led to a sustained partial remission. In particular, the well-tolerated regimen of bortezomib, cyclophosphamide and dexamethasone together with pomalidomide was administered for >30 cycles. Conclusion: This case illustrates the value of an individualized approach to myeloma care given an increasing availability of ‘novel agents'. Tailored treatment using these drugs as a backbone is essential to achieve long-lasting responses and minimize side effects.

A432 Long-Term Treatment with Lenalidomide in Previously Treated Subjects with Multiple Myeloma

2009 ◽  
Vol 9 ◽  
pp. S68-S69
Author(s):  
AA Amor ◽  
B Aguado ◽  
C Camara ◽  
A Velasco ◽  
F Garcia-Escribano
Keyword(s):  
Multiple Myeloma ◽  
Term Treatment ◽  
Long Term Treatment ◽  
Previously Treated

scholarly journals Bonanza of New Treatment Regimens for Multiple Myeloma: What Is Right for My Patient?

2020 ◽  
Vol 18 (12.5) ◽  
pp. 1773-1776
Author(s):  
Shaji K. Kumar
Keyword(s):  
Multiple Myeloma ◽  
Chronic Disease ◽  
Treatment Strategy ◽  
Term Treatment ◽  
New Agents ◽  
Treatment Regimens ◽  
Recent Advances ◽  
Long Term Treatment ◽  
New Treatment

Although recent advances in the treatment of multiple myeloma have improved survival, it remains a chronic disease that requires a long-term treatment strategy. The key to achieving the best outcomes for patients is delivering the best “package” of treatment at a given stage. This means using optimal combinations that maximize benefit based on what patients have received previously and minimize treatment-related toxicity. Sequencing of regimens also plays an important role. As new agents and new classes of drugs continue to be approved for multiple myeloma, future strategies will use more individualized approaches to treatment.

Long-term treatment of newly-diagnosed multiple myeloma with low-dose thalidomide, dexamethasone and zoledronate (TDZ)

2005 ◽  
Vol 23 (16_suppl) ◽  
pp. 6697-6697 ◽  
Author(s):  
U. Klueppelberg ◽  
I. Shapira ◽  
L. Chen ◽  
M. C. Aloba ◽  
E. Smith ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Low Dose ◽  
Term Treatment ◽  
Newly Diagnosed ◽  
Long Term Treatment
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