Lenalidomide and dexamethasone in relapsed/refractory multiple myeloma

This study examined the effect of lenalidomide (Revlimid) and dexamethasone in patients with multiple myeloma. This study concluded that the treatment combination was effective and results were similar to that seen in clinical trials.

Lenalidomide is a type of immunotherapy (stimulates the immune system to fight the cancer) used in patients with untreated multiple myeloma who cannot have a stem cell transplant. A combination of lenalidomide and dexamethasone is approved for use in refractory (did not respond to treatment) or relapsed multiple myeloma. Lenalidomide in combination with dexamethasone has shown to improve survival in clinical trials.

98 patients with relapsing or refractory multiple myeloma were studied. The study was performed in a routine clinical setting. All patients received lenalidomide and dexamethasone. 47 patients received it as a second-line therapy (second type of treatment after first type failed). 51 patients received it as a third-line or higher-line therapy. The average follow-up time was 40.1 months.

Overall, 73.5% of patients had worsening of disease. The overall average time for disease to worsen was 12 months. Among patients who received lenalidomide and dexamethasone as second-line therapy, the average time for disease to worsen was 13.9 months. Among patients who received it as a third-line or higher line therapy, the average time for disease to worsen was 10.3 months.

Average overall survival was 24.3 months. In patients who received lenalidomide and dexamethasone as a second-line therapy, average survival was 35.5 months. The average survival was 21.1 months in patients who had it as a third-line or higher line therapy.  

The most common negative side effects were low levels of red blood cells (32.7%), white blood cells (24.5%), and platelets (27.65). 15.3% of patients had fatigue. 14.3% of patients had diarrhea. 11.2% of patients had shortness of breath. No patient died because of a treatment-related adverse event.

The authors concluded that a combination of lenalidomide and dexamethasone is safe and effective.