Longer Maintenance Therapy With Lenalidomide May Improve Survival for Multiple Myeloma Patients

Compared with patients diagnosed with multiple myeloma (MM) who were treated with lenalidomide maintenance therapy for ≤2 years, those who received maintenance therapy for longer than two years had longer progression-free survival (PFS) and overall survival (OS), according to a study published in Cancer.

Idrees Mian, MD, of the Internal Medicine Residency Program at The University of Texas Health Science Center at Houston, and authors conducted a retrospective analysis of 464 patients who received maintenance therapy with lenalidomide after undergoing an autologous hematopoietic cell transplant between January 2007 and December 2013.

Overall, the median PFS was 38 months, and the median OS was 78 months. Patients who received longer lenalidomide maintenance therapy had improved PFS (hazard ratio [HR] = 0.13; 95% CI 0.04-0.38; p<0.001) and OS (HR=0.09; 95% CI 0.03-0.26; p<0.001), compared with those who were treated for ≤2 years. In addition, the trend toward improved PFS (HR=0.02; 95% CI 0-0.44; p=0.012) and OS (HR=0.05; 95% CI 0-0.83; p=0.037) continued for patients who were treated for >3 years versus ≤3 years.

Longer lenalidomide maintenance therapy was associated with an 87 percent decrease in disease progression and a 91 percent reduction in risk of mortality (p<0.001 for both).

“The incidence of second primary malignancies was low, and they were not associated with the duration of maintenance,” Dr. Mian and colleagues concluded. “The timing of the initiation of maintenance had no effect on survival.”

Source: Mian I, Milton DR, Shah N, et al. Prolonged survival with a longer duration of maintenance lenalidomide after autologous hematopoietic stem cell transplantation for multiple myeloma. Cancer. 2016 September 28. [Epub ahead of print]