Revlimid maintenance may prevent multiple myeloma relapse

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A prospective randomized trial carried out by French researchers examined whether maintenance therapy with lenalidomide (Revlimid) could help prevent disease relapse in multiple myeloma patients following an autologous stem-cell transplant in patients under age 65. The findings suggests that such therapy cut the risk of recurrence by 54% after three years.

Multiple myeloma is a notoriously difficult-to-treat cancer of the plasma cells. Approximately 20,000 people in the US are annually diagnosed with the disease, and about 10,000 die from it each year.

Lenalidomide is an analogue of the infamous and disastrous 1960s drug thalidomide, which was directly linked to birth defects and other problems before pulled from the market. Unlike its cousin, lenalidomide appears to be well-tolerated, and is currently approved by the FDA for second line treatment of multiple myeloma along with myelodysplastic syndromes (MDS).

COHORT

614 patients received two months of oral lenalidomide consolidation therapy @ 25 mg/day. Then they were randomized either to placebo or to lenalidomide (10-15 mg/day) until relapse.

RESULTS

Follow-up at three years.

Placebo arm:
143 of 307 patients experienced disease progression or died.
Progression-free survival (PFS): 34% at three years

Lenalidomide arm:
77 of 307 patients experienced disease progression or died.
Progression-free survival (PFS): 68% at three years

CONCLUSIONS

Researchers believe that multiple myeloma is slowly moving towards becoming a chronic disease thanks to potential maintenance therapies as the one presented in this abstract.

PUBLICATIONS

These results were presented in a press conference for the upcoming 2010 American Society of Clinical Oncology (ASCO) Annual Meeting; they have not been published in a peer-reviewed journal yet and until then should be considered preliminary only.

By Ross Bonander

Source: Attal M et al. "Lenalidomide maintenance after transplantation for myeloma" ASCO 2010; Abstract 8018.

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