Mar 03, 2016 multiple myeloma mm is the second most frequent hematologic cancer, with a median age at diagnosis of. 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 novel agents consistently improved progressionfree survival pfs compared with. Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma skip to main content thank you for visiting. Continuous treatment with lenalidomide and lowdose dexamethasone in transplantineligible patients with newly diagnosed multiple myeloma in asia. Continuous lenalidomide treatment after bortezomibmelphalan. Revlimid lenalidomide, an immunomodulatory drug imid, is the first oral medication that was developed for treatment of multiple myeloma. Ask dr durie everything you need to know about continuous.
The treatment of multiple myeloma changed with thalidomide thalomid, celgene corporation, but its use was limited by toxicity, explained dr richardson. The primary end point was progressionfree survival pfs. Continuous therapy with lenalidomide in multiple myeloma by nizar bahlis, md. What are neurologic symptoms in multiple myeloma mm.
Multiple myeloma mm accounts for 1% of all cancers and. The data were presented during the european haematology associations annual congress in barcelona, spain. Continuous therapy with lenalidomide in multiple myeloma. Mprr significantly prolonged progressionfree survival in patients with newly di agnosed multiple myeloma who were ineligible for. 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. The therapeutic approach for newly diagnosed multiple myeloma today consists of an induction phase with novel agent com.
Multiple myeloma mm is a plasma cells disorder that accounts for approximately % of all hematologic cancers. Continuous lenalidomide treatment after bortezomib. Update on the initial therapy of multiple myeloma ariez publishing. 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. Melphalan, prednisone, and lenalidomide treatment for newly diagnosed myeloma. 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. Developments in continuous therapy and maintenance treatment. Continuous lenalidomide treatment for newly diagnosed multiple myeloma new england journal of medicine, 366 2012, pp. Pdf lenalidomide maintenance versus observation for patients. Lenalidomide after stemcell transplantation for multiple myeloma. Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma article in annals of hematology 995 april 2020 with 8 reads. In patients with newly diagnosed multiple myeloma, how to maintain the. Pdf continuous lenalidomide treatment for newly diagnosed.
Lee,2 shangyi huang,3 lugui qiu,4 jejung lee,5 ting liu,6 sungsoo yoon,7 kihyun kim,8 zhi x. Continuous lenalidomide and lowdose dexamethasone for the. Because maintenance treatment is administered as continuous. 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. Background lenalidomide has tumoricidal and immunomodulatory activity against multiple myeloma. Lenalidomide maintenance versus observation for patients.
Continuous treatment with new agents for newly diagnosed. New england journal of medicine reports on three phase iii. Multiple myeloma had been successfully treated by combining lenalidomide and bortezomib with reports suggesting benefits of such a combination even in relapsedrefractory cases. Original article from the new england journal of medicine continuous lenalidomide treatment for newly diagnosed multiple myeloma. It is used in the newly diagnosed, maintenance therapy, and relapsed andor refractory settings. On february 18, 2015, the indication for lenalidomide revlimid in combination with dexamethasone was expanded to include patients with 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.
Most patients with newly diagnosed multiple myeloma have achieved. Melphalan, prednisone, and lenalidomide versus melphalan, prednisone, and thalidomide in untreated multiple myeloma. Myeloma working group imwg subdivides relapse into dr. Currently lenalidomide plus dexamethasone rd is one of the standard treatments. In conclusion, continuous lenalidomide regimens provide an effective longerterm treatment option in patients with newly diagnosed multiple myeloma ineligible for stemcell transplantation. Treatment of patients with newly diagnosed multiple myeloma. Mar 26, 2020 continuous lenalidomide treatment for newly diagnosed multiple myeloma. 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. Most patients with newly diagnosed multiple myeloma. May 10, 2012 continuous lenalidomide treatment for newly diagnosed multiple myeloma.
Continuous lenalidomide treatment after bortezomibmelphalanprednisolone therapy for newly diagnosed multiple myeloma. Continuous lenalidomide therapy nontransplant eligible population. The manageable safety profile of this drug and the encouraging results in subgroup analyses of patients across all cytogenetic. Lenalidomide as maintenance for every newly diagnosed patient. Lenalidomide maintenance after autologous stemcell transplantation in newly diagnosed multiple myeloma. Continuous lenalidomide deemed a standard of care for newly. Observation following nonimmunomodulatory compound based induction therapy in newly diagnosed multiple myeloma ndmm. Continuous therapy in standard and highrisk newlydiagnosed. 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. Secondary end points included overall survival os, overall response. Treatment of patients with multiple myeloma progressing on frontlinetherapy with lenalidomide skip to main content thank you for visiting. 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.
Gmmgmm5 responseadapted lenalidomide maintenance in newly. Lenalidomide in combination with dexamethasone in newly. Revlimid lenalidomide international myeloma foundation. Lenalidomide has significant activity in the setting of multiple myeloma. Lenalidomide maintenance versus observation for patients with. Developments in continuous therapy and maintenance. 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 in combination with dexamethasone is effective in relapsed or refractory multiple myeloma 46 and in 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. Treatment of patients with multiple myeloma progressing on.
Sequential therapy of four cycles of bortezomib, melphalan. Continuous therapy versus fixed duration of therapy in. Multiple myeloma accounts for around 1% of all cancers worldwide and 1015% of all hematological neoplasms. Continuous treatment had typically been reserved for patients who relapsed following 72. Mar 09, 2020 lenalidomide len maintenance therapy is the standard of care in newly diagnosed multiple myeloma ndmm following highdose melphalan hdm. Continuous lenalidomide treatment for newly diagnosed multiple myeloma. Lenalidomide now for newly diagnosed multiple myeloma patients. How lenalidomide is changing the treatment of patients with. Outcomes in patients with multiple myeloma mm have improved substantially over the past two decades. Currently, treatment of newly diagnosed mm ndmm patients is differentiated according to transplanteligibility. Continuous lenalidomide deemed a standard of care for newly diagnosed multiple 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. 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. Continuous lenalidomide treatment for newly diagnosed multiple. Treatment outcomes in patients with newly diagnosed multiple. Continuous lenalidomide treatment for newly diagnosed. Triplet vs doublet lenalidomidecontaining regimens for the. Almost all patients with mm evolve from an asymptomatic premalignant stage termed monoclonal gammopathy of undetermined significance mgus. Continuous lenalidomide treatment for newly diagnosed multiple myeloma mm015 this doubleblind, phase iii, multicenter. 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. Updated results of phase iii study evaluating continuous. The incidence of most adverse events began to reduce after about 18 months of therapy. The first article highlights a celgene sponsored study of continuous lenalidomide treatment in elderly patients newly diagnosed with multiple myeloma. 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. Recently, it was demonstrated that ikaros degradation by lenalidomide happens via proteasomedependent pathway and this process is critical for the eradication of myeloma cells. Longterm treatment approaches for patients with newly.
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