Retreatment with lenalidomide is an effective option in heavily pretreated refractory multiple myeloma patients

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Title in English Retreatment with lenalidomide is an effective option in heavily pretreated refractory multiple myeloma patients.
Authors

ŠTORK Martin ŠEVČÍKOVÁ Sabina ADAM Zdeněk KREJČÍ Marta SANDECKÁ Viera KRÁL Zdeněk BROŽOVÁ Lucie VELICHOVÁ Roberta POUR Luděk

Year of publication 2018
Type Article in Periodical
Magazine / Source Neoplasma
MU Faculty or unit

Faculty of Medicine

Citation
Doi http://dx.doi.org/10.4149/neo_2018_170519N363
Keywords multiple myeloma; lenalidomide; retreatment
Description The combination of lenalidomide and dexamethasone is the current gold standard for treatment of relapsed multiple myeloma. This study analyzes the efficiency of repeated lenalidomide treatment in patients with relapsed and refractory multiple myeloma. A total of 41 patients were prospectively evaluated at the University Hospital Brno. Lenalidomide was administered at standard dosing and in combination with corticosteroids and/or chemotherapy. The maximum cumulative dose of lenalidomide was limited to 4,200 mg because of Czech health insurance rules. Before the second lenalidomide treatment, all patients were refractory to the last treatment; previously, 95% of patients had bortezomib treatment, 48% had autologous transplantation and the median number of prior therapy lines was three. A partial 14.2% or better response was achieved with the second lenalidomide treatment. The median progression-free survival was 4.8 months, and median overall survival was 11.9 months. Unfortunately, predicting risk factors in lenalidomide retreatment proved unsuccessful. Although our treatment results were significantly affected by limited Czech health care system coverage for lenalidomide, we established that its repeated treatment is an effective therapeutic alternative for heavily pretreated patients with relapsed and refractory multiple myeloma.
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