Lenalidomide in combination with dexamethasone at first relapse in comparison with its use as later salvage therapy in relapsed or refractory multiple myeloma
Identifieur interne : 002F96 ( Istex/Corpus ); précédent : 002F95; suivant : 002F97Lenalidomide in combination with dexamethasone at first relapse in comparison with its use as later salvage therapy in relapsed or refractory multiple myeloma
Auteurs : Edward A. Stadtmauer ; Donna M. Weber ; Ruben Niesvizky ; Andrew Belch ; Miles H. Prince ; Jesús F. San Miguel ; Thierry Facon ; Marta Olesnyckyj ; Zhinuan Yu ; Jerome B. Zeldis ; Robert D. Knight ; Meletios A. DimopoulosSource :
- European Journal of Haematology [ 0902-4441 ] ; 2009-06.
English descriptors
- KwdEn :
- Abramson cancer center, Adverse events, Authors journal compilation, Baseline, Baseline characteristics, Blackwell munksgaard lenalidomide, Blackwell munksgaard stadtmauer, Bortezomib, Celgene, Celgene corporation, Cell transplantation, Combination therapy, Complete response, Dexamethasone, Dexamethasone treatment, Disease progression, Disease response, Dose reduction, European group, Further analysis, Grant support, Hazard ratio, Independent committee, International uniform response criteria, Last evaluation, Lecture fees, Lenalidomide, Lenalidomide treatment, Median, Median duration, More therapies, Multiple myeloma, Multivariate analysis, Munksgaard, Myeloma, National cancer institute, Novel agents, Overall survival, Peripheral neuropathy, Preliminary analysis, Progression, Relapse, Response rates, Separate line, Stadtmauer, Subset analysis, Thalidomide, Thalidomide treatment, Therapies lenalidomide, Therapy, Thrombotic events, Toxicity.
- Teeft :
- Abramson cancer center, Adverse events, Authors journal compilation, Baseline, Baseline characteristics, Blackwell munksgaard lenalidomide, Blackwell munksgaard stadtmauer, Bortezomib, Celgene, Celgene corporation, Cell transplantation, Combination therapy, Complete response, Dexamethasone, Dexamethasone treatment, Disease progression, Disease response, Dose reduction, European group, Further analysis, Grant support, Hazard ratio, Independent committee, International uniform response criteria, Last evaluation, Lecture fees, Lenalidomide, Lenalidomide treatment, Median, Median duration, More therapies, Multiple myeloma, Multivariate analysis, Munksgaard, Myeloma, National cancer institute, Novel agents, Overall survival, Peripheral neuropathy, Preliminary analysis, Progression, Relapse, Response rates, Separate line, Stadtmauer, Subset analysis, Thalidomide, Thalidomide treatment, Therapies lenalidomide, Therapy, Thrombotic events, Toxicity.
Abstract
This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β2‐microglobulin (≤2.5 mg/L), predicted a better time to progression (TTP; study end‐point) with lenalidomide plus dexamethasone treatment. Patients with one prior therapy showed a significant improvement in benefit after first relapse compared with those who received two or more therapies. Patients with one prior therapy had significantly prolonged median TTP (17.1 vs. 10.6 months; P = 0.026) and progression‐free survival (14.1 vs. 9.5 months, P = 0.047) compared with patients treated in later lines. Overall response rates were higher (66.9% vs. 56.8%, P = 0.06), and the complete response plus very good partial response rate was significantly higher in first relapse (39.8% vs. 27.7%, P = 0.025). Importantly, overall survival was significantly prolonged for patients treated with lenalidomide plus dexamethasone with one prior therapy, compared with patients treated later in salvage (median of 42.0 vs. 35.8 months, P = 0.041), with no differences in toxicity, dose reductions, or discontinuations despite longer treatment. Therefore, lenalidomide plus dexamethasone is both effective and tolerable for second‐line MM therapy and the data suggest that the greatest benefit occurs with earlier use.
Url:
DOI: 10.1111/j.1600-0609.2009.01257.x
Links to Exploration step
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<front><div type="abstract" xml:lang="en">This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β2‐microglobulin (≤2.5 mg/L), predicted a better time to progression (TTP; study end‐point) with lenalidomide plus dexamethasone treatment. Patients with one prior therapy showed a significant improvement in benefit after first relapse compared with those who received two or more therapies. Patients with one prior therapy had significantly prolonged median TTP (17.1 vs. 10.6 months; P = 0.026) and progression‐free survival (14.1 vs. 9.5 months, P = 0.047) compared with patients treated in later lines. Overall response rates were higher (66.9% vs. 56.8%, P = 0.06), and the complete response plus very good partial response rate was significantly higher in first relapse (39.8% vs. 27.7%, P = 0.025). Importantly, overall survival was significantly prolonged for patients treated with lenalidomide plus dexamethasone with one prior therapy, compared with patients treated later in salvage (median of 42.0 vs. 35.8 months, P = 0.041), with no differences in toxicity, dose reductions, or discontinuations despite longer treatment. Therefore, lenalidomide plus dexamethasone is both effective and tolerable for second‐line MM therapy and the data suggest that the greatest benefit occurs with earlier use.</div>
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<abstract>This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β2‐microglobulin (≤2.5 mg/L), predicted a better time to progression (TTP; study end‐point) with lenalidomide plus dexamethasone treatment. Patients with one prior therapy showed a significant improvement in benefit after first relapse compared with those who received two or more therapies. Patients with one prior therapy had significantly prolonged median TTP (17.1 vs. 10.6 months; P = 0.026) and progression‐free survival (14.1 vs. 9.5 months, P = 0.047) compared with patients treated in later lines. Overall response rates were higher (66.9% vs. 56.8%, P = 0.06), and the complete response plus very good partial response rate was significantly higher in first relapse (39.8% vs. 27.7%, P = 0.025). Importantly, overall survival was significantly prolonged for patients treated with lenalidomide plus dexamethasone with one prior therapy, compared with patients treated later in salvage (median of 42.0 vs. 35.8 months, P = 0.041), with no differences in toxicity, dose reductions, or discontinuations despite longer treatment. Therefore, lenalidomide plus dexamethasone is both effective and tolerable for second‐line MM therapy and the data suggest that the greatest benefit occurs with earlier use.</abstract>
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<p>This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β<hi rend="subscript">2</hi>
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0.041), with no differences in toxicity, dose reductions, or discontinuations despite longer treatment. Therefore, lenalidomide plus dexamethasone is both effective and tolerable for second‐line MM therapy and the data suggest that the greatest benefit occurs with earlier use.</p>
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<p>This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β<sub>2</sub>
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<affiliation>Servicio de Hematología, Hospital Universitario de Salamanca, CIC, IBMCC (USAL‐CSIC), Salamanca, Spain</affiliation>
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<name type="personal"><namePart type="given">Thierry</namePart>
<namePart type="family">Facon</namePart>
<affiliation>Hôpital Claude Huriez, Lille, France</affiliation>
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</name>
<name type="personal"><namePart type="given">Marta</namePart>
<namePart type="family">Olesnyckyj</namePart>
<affiliation>Celgene Corporation, Summit, NJ, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Zhinuan</namePart>
<namePart type="family">Yu</namePart>
<affiliation>Celgene Corporation, Summit, NJ, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
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<name type="personal"><namePart type="given">Jerome B.</namePart>
<namePart type="family">Zeldis</namePart>
<affiliation>Celgene Corporation, Summit, NJ, USA</affiliation>
<role><roleTerm type="text">author</roleTerm>
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<name type="personal"><namePart type="given">Robert D.</namePart>
<namePart type="family">Knight</namePart>
<affiliation>Celgene Corporation, Summit, NJ, USA</affiliation>
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<name type="personal"><namePart type="given">Meletios A.</namePart>
<namePart type="family">Dimopoulos</namePart>
<affiliation>University of Athens School of Medicine, Athens, Greece</affiliation>
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<place><placeTerm type="text">Oxford, UK</placeTerm>
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<dateIssued encoding="w3cdtf">2009-06</dateIssued>
<edition>Accepted for publication 9 March 2009</edition>
<copyrightDate encoding="w3cdtf">2009</copyrightDate>
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<abstract lang="en">This subset analysis of data from two phase III studies in patients with relapsed or refractory multiple myeloma (MM) evaluated the benefit of initiating lenalidomide plus dexamethasone at first relapse. Multivariate analysis showed that fewer prior therapies, along with β2‐microglobulin (≤2.5 mg/L), predicted a better time to progression (TTP; study end‐point) with lenalidomide plus dexamethasone treatment. Patients with one prior therapy showed a significant improvement in benefit after first relapse compared with those who received two or more therapies. Patients with one prior therapy had significantly prolonged median TTP (17.1 vs. 10.6 months; P = 0.026) and progression‐free survival (14.1 vs. 9.5 months, P = 0.047) compared with patients treated in later lines. Overall response rates were higher (66.9% vs. 56.8%, P = 0.06), and the complete response plus very good partial response rate was significantly higher in first relapse (39.8% vs. 27.7%, P = 0.025). Importantly, overall survival was significantly prolonged for patients treated with lenalidomide plus dexamethasone with one prior therapy, compared with patients treated later in salvage (median of 42.0 vs. 35.8 months, P = 0.041), with no differences in toxicity, dose reductions, or discontinuations despite longer treatment. Therefore, lenalidomide plus dexamethasone is both effective and tolerable for second‐line MM therapy and the data suggest that the greatest benefit occurs with earlier use.</abstract>
<subject lang="en"><genre>keywords</genre>
<topic>lenalidomide</topic>
<topic>multiple myeloma</topic>
<topic>relapse</topic>
<topic>time to progression</topic>
<topic>survival</topic>
</subject>
<relatedItem type="host"><titleInfo><title>European Journal of Haematology</title>
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<identifier type="ISSN">0902-4441</identifier>
<identifier type="eISSN">1600-0609</identifier>
<identifier type="DOI">10.1111/(ISSN)1600-0609</identifier>
<identifier type="PublisherID">EJH</identifier>
<part><date>2009</date>
<detail type="volume"><caption>vol.</caption>
<number>82</number>
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<detail type="issue"><caption>no.</caption>
<number>6</number>
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<extent unit="pages"><start>426</start>
<end>432</end>
<total>7</total>
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<identifier type="ark">ark:/67375/WNG-K7RP9217-V</identifier>
<identifier type="DOI">10.1111/j.1600-0609.2009.01257.x</identifier>
<identifier type="ArticleID">EJH1257</identifier>
<accessCondition type="use and reproduction" contentType="copyright">© 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard</accessCondition>
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