Safety of lenalidomide for maintenance treatment of patients with multiple myeloma following autologous stem cell transplantation. Issue 10 (3rd October 2021)

• Record Type: Journal Article
• Authors: Jones, John R; Pawlyn, Charlotte; Jackson, Graham H
• Is Part Of: Expert opinion on drug safety. Volume 20:Issue 10(2021)
• Page Start: 1137
• Page End: 1145
• Publication Date: 2021-10-03
• Subjects: Lenalidomide -- immunomodulatory agent -- maintenance -- continuous therapy -- overall survival -- progression free survival; Drugs -- Side effects -- Periodicals; Drugs -- Toxicology -- Periodicals; Chemotherapy -- Periodicals; 615.704
• DOI: 10.1080/14740338.2021.1945578
• Languages: English
• ISSNs: 1474-0338

Abstract

ABSTRACT: Introduction: Myeloma is the second most common hematological cancer, with 5800 cases per year diagnosed in the UK. Despite improved treatment it is still considered non-curable, although the median survival has increased from 3 to 8 years over the past 20 years. Treatment involves the use of induction therapy and consolidation with autologous stem cell transplant (ASCT) in patients deemed fit enough. Further attempts to improve outcomes include the use of maintenance therapy. Areas covered: This review details all trials in which lenalidomide has been used as maintenance following ASCT. PubMed searches included randomized control trials, observational cohort, reviews, and meta-analysis. Expert opinion: Lenalidomide is a well-tolerated, oral agent that is associated with increased overall and progression free survival when used as maintenance following ASCT. Its use in this setting is FDA and EMA approved and is standard of care in Europe and North America. The early link between lenalidomide and second hematological cancers appears to be associated with use in combination with melphalan. There is an increase in non-melanoma skin cancers and solid tumors in the elderly but this has minimal impact on mortality. Lenalidomide use as part of combination maintenance is underway and may further improve outcomes.