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

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

Rok publikování 2018
Druh Článek v odborném periodiku
Časopis / Zdroj Neoplasma
Fakulta / Pracoviště MU

Lékařská fakulta

Citace
Doi http://dx.doi.org/10.4149/neo_2018_170519N363
Klíčová slova multiple myeloma; lenalidomide; retreatment
Popis 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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