Revlimid Therapy May Delay Myeloma Progression and Increase Survival

Revlimid (lenalidomide) therapy maintenance has been shown to delay disease progression and extend survival in newly diagnosed multiple myeloma (NDMM) patients who receive a transplant of their own blood-forming stem cells, called autologous stem-cell transplantation (ASCT).

The findings include data of 1,208 NDMM patients and were reported in a study titled “Lenalidomide Maintenance After Autologous Stem-Cell Transplantation in Newly Diagnosed Multiple Myeloma: A Meta-Analysis” and published in the Journal of Clinical Oncology.

NDMM patients typically undergo high-dose chemotherapy that kills myeloma cells. This treatment, however, also kills the patient’s healthy blood cells. To address this, patients have their blood-forming stem cells harvested from bone marrow or peripheral blood and stored before treatment begins. Therefore, after the chemo, they receive back their own cells (autologous) in a transplant, which makes patients capable of generating new blood cells.

Following ASCT, therapy maintenance, which could include Revlimid, may increase patients’ time without disease (progression-free survival) and improve overall survival.

In this study, the team pooled data from three different clinical trials (ClinicalTrials.gov numbers NCT00114101, NCT00430365, and NCT00551928) that included patients who underwent ASCT followed by Revlimid therapy or placebo. After ASCT, 605 of these patients maintained the Revlimid therapy and 603 received the placebo or were under observation.

The research team found that the median progression-free survival in the Revlimid treatment group (52.8 months) was more than double the control group (23.5 months). In addition, the seven-year survival rate was 62% with Revlimid maintenance versus 50% in the control group.

The team did not report any new adverse effects of long Revlimid treatment. However, discontinuation rates due to treatment-emergent adverse events were 29.1% with Revlimid and 12.2% in the control group. The most commonly reported problems that led to discontinuation were hematologic, including neutropenia and thrombocytopenia.

“Achieving remission and maintaining long-term disease control are critical aims when treating newly diagnosed patients. In this context, Revlimid has been shown to delay disease progression, prolong the time before the next line of treatment is needed, and ultimately extend survival. It can therefore now be considered a standard of care for these patients,” Michel Attal, the senior author of this study, said in a press release.