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The impact of lenalidomide maintenance on second‐line chemotherapy in transplant eligible patients with multiple myeloma
Author(s) -
Cherniawsky Hannah M.,
Kukreti Vishal,
Reece Donna,
MasihKhan Esther,
McCurdy Arleigh,
JimenezZepeda Victor H.,
Sebag Michael,
Song Kevin,
White Darrell,
Stakiw Julie,
LeBlanc Richard,
Reiman Anthony,
Louzada Martha,
Aslam Muhammad,
Kotb Rami,
Gul Engin,
Atenafu Eshetu,
Venner Christopher P.
Publication year - 2021
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13596
Subject(s) - lenalidomide , medicine , multiple myeloma , oncology , cohort , maintenance therapy , thalidomide , chemotherapy , surgery
Objectives To understand the impact of therapy sequencing on progression‐free (PFS) and overall survival (OS) for the treatment of multiple myeloma (MM). The use of daily, low‐dose, lenalidomide maintenance (LM) has raised concern for fostering resistance, preventing its use in the relapsed setting. Methods We conducted a retrospective analysis of survival outcomes from the Canadian Myeloma Research Group Database. Patients were grouped based on receipt of LM after autologous stem cell transplant and receipt of lenalidomide in second‐line therapy, 575 patients were included. Results Patients treated with LM had statistically similar 2nd PFS when re‐exposed to lenalidomide in second‐line therapy compared to those receiving non‐lenalidomide‐containing regimens (10.2 vs 14.0 months, P =.53). This cohort also had the longest 2nd OS, 18 months longer than patients treated with LM who did not receive lenalidomide at relapse (55.3 vs 37 months, P =.004). Patients treated with LM also demonstrated deeper responses to second‐line therapy than their non‐LM counterparts. Conclusion Our data suggest that patients progressing on LM who receive lenalidomide‐containing therapy at first relapse have comparable 2nd PFS and better 2nd OS compared to non‐lenalidomide‐containing second‐line regimens. Identification of patients mostly likely to benefit from further lenalidomide‐containing therapy is paramount.