Efficacy and safety of lenalidomide treatment in multiple myeloma (MM) patients-Report of the Polish Myeloma Group

被引:5
|
作者
Usnarska-Zubkiewicz, L. [1 ]
Debski, J. [1 ]
Butrym, A. [1 ,2 ]
Legiec, W. [3 ]
Hus, M. [3 ]
Dmoszynska, A. [3 ]
Stella-Holowiecka, B. [4 ]
Zaucha, J. M. [5 ]
Januszczyk, J. [5 ]
Rymko, M. [6 ]
Torosian, T. [7 ]
Charlinski, G. [7 ]
Lech-Maranda, E. [8 ,9 ]
Malenda, A. [8 ]
Jurczyszyn, A. [10 ]
Urbariska-Rys, H. [11 ]
Druzd-Sitek, A. [12 ,13 ]
Blonska, D. [14 ]
Urbanowicz, A. [15 ]
Holojda, J. [16 ]
Pogrzeba, J. [17 ]
Rzepecki, P. [18 ]
Halka, J. [18 ]
Subocz, E. [18 ]
Becht, R. [19 ]
Zdziarska, B. [19 ]
Dytfeld, D. [20 ]
Nowicki, A. [20 ]
Bolkun, L. [21 ]
Kloczko, J. [21 ]
Knopinska-Posluszny, W. [22 ]
Zubkiewicz-Kucharska, A. [23 ]
Kuliczkowski, K. [1 ]
机构
[1] Wroclaw Med Univ, Dept Haematol Blood Neoplasms & Bone Manow Transp, Wroclaw, Poland
[2] Wroclaw Med Univ, Dept Physiol, Wroclaw, Poland
[3] Med Univ Lublin, Dept Haematol & Bone Manow Transplantat, Lublin, Poland
[4] Med Univ Silesia, Dept Haematol & Bone Manow Transplantat, Katowice, Poland
[5] Gdynia Oncol Ctr, Gdynia, Poland
[6] Dist Hosp Torun, Dept Haematol, Torun, Poland
[7] Med Univ Warsaw, Dept Haematol Oncol & Internal Med, Warsaw, Poland
[8] Inst Hematol & Blood Transfus, Dept Haematol, Warsaw, Poland
[9] Ctr Postgrad Med Educ, Warsaw, Poland
[10] Jagiellonian Univ, Coll Med, Dept Haematol, Krakow, Poland
[11] Med Univ Lodz, Dept Haematol, Lodz, Poland
[12] Maria Sklodowska Curie Mem Inst Oncol, Dept Lymphoproliferat Dis, Warsaw, Poland
[13] Ctr Oncol, Warsaw, Poland
[14] Dept Haematol & Neoplasmat Dis Haematopoiesis, Bydgoszcz, Poland
[15] Dist Hosp Suwalki, Dept Clin Oncol & Haematol, Suwalki, Poland
[16] Dist Specialist Hosp Legnica, Dept Haematol, Legnica, Poland
[17] Dist Hosp Opole, Dept Haematol & Haematooncol, Opole, Poland
[18] Minist Natl Def, Cent Clin Hosp, Mil Inst Med, Dept Internal Dis & Haematol, Warsaw, Poland
[19] Pomeranian Med Univ, Dept Haematol, Szczecin, Poland
[20] Poznan Univ Med Sci, Dept Haematol & Bone Manow Transplantat, Poznan, Poland
[21] Univ Clin Hosp Bialystok, Dept Haematol, Bialystok, Poland
[22] Warmia & Masuria Oncol Ctr, Minist Interior Hosp Olsztyn, Warmia, Poland
[23] Wroclaw Med Univ, Dept Endocrinol & Diabetol Children & Adolescents, Wroclaw, Poland
关键词
Multiple myeloma; Lenalidomide; Efficacy; Safety; PLUS DEXAMETHASONE; FOLLOW-UP; THERAPY; THALIDOMIDE; THROMBOSIS; SURVIVAL;
D O I
10.1016/j.leukres.2015.11.005
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The aim of the multi-centre retrospective study was to evaluate the efficacy and safety of lenalidomide (LEN) therapy in patients with resistant or relapsed multiple myeloma (MM) as well as in patients with stable disease (LEN used due to neurological complications). The primary endpoint of this study was an overall response rate (ORR). The secondary endpoints were as follows: time to progression (TTP), overall survival (OS) and the safety of drug use. Data were collected in 19 centres of the Polish Multiple Myeloma Study Group. The study group consisted of 306 subjects: 153 females and 153 males. In 115 patients (38.8%, group A), a resistant myeloma was diagnosed; in 135 (44.1%, group B) a relapse, and in 56(18.3%, group C) a stable disease were stated. In 92.8% of patients, LEN + DEX combination was used; in remaining group, LEN monotherapy or a combination therapy LEN + bortezomib or LEN + bendamustine and other were used. In the entire study group, ORR was 75.5% (including 12.4% patients achieving complete remission [CR] or stringent CR [sCR]). Median time to progression (UP) was 20 months. Median overall survival (OS) was 33.3 months. The regression model for "treatment response" was on the borderline of statistical significance (p = 0.07), however the number of LEN treatment cycles >= 6 (R-2 = 17.2%), baseline LDH level (R-2 = 1.1%) and no ASCT use (R-2 = 1.7%) where the factors most affecting treatment response achievement. The regression model for dependant variable - "overall survival" - was statistically significant (p = 0.0000004). Factors with the most impact on OS were as follows: number of LEN cycles treatment >= 6 (R-2 = 16.7%), treatment response achievement (R-2 = 6.9%), beta-2-microglobulin (beta-2-M) level (R-2 = 4.8%), renal function (R-2 = 3.0%) and lack of 314 grade adverse events (R-2 = 1.4%). Summary: LEN is an effective and safe therapeutic option, even in intensively treated resistant and relapsed MM patients, as well as in patients with stable disease and previous treatment-induced neurological complications. In particular, the number of LEN treatment cycles >= 6 was the factor which affected treatment response achievement the most, together with an important impact on OS. (C) 2015 Elsevier Ltd. All rights reserved.
引用
收藏
页码:90 / 99
页数:10
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