[well365]

Revlimid secondary cancers

by well365 on Tue Nov 27, 2012 4:02 pm

Has anyone experienced secondary cancers after taking Revlimid? Specifically breast cancers?

[Riza43]

Re: Revlimid secondary cancers

by Riza43 on Fri Aug 16, 2013 2:27 pm

I was on Revlimid (25 mg) and Dex for 6 months as initial treatment from February 2011 to August 2011. I developed Carcinoid Tumor. I had to have an appendectomy and that is how they found it. I was lucky. The tumor was very small and the cancer has not re-occurred. I have been off all drugs since then.

My numbers are coming up again and I had a bone marrow biopsy a couple of weeks ago. I will find out the results on Monday. My question is: Has anyone gotten a secondary cancer that quickly on Revlimid? Do I have to worry about a recurrence on another drug? My oncologist has mentioned Velcade as a possible next treatment. Any suggestions, input?

Thanks...

[Dr. Ken Shain]

Re: Revlimid secondary cancers

by Dr. Ken Shain on Sat Aug 17, 2013 9:44 am

I am glad to hear that everything was taken care for you.

The discussion of Rev and second primary malignancies appears to be focused on a relatively specific aspect of myeloma therapy- maintenance therapy post melphalan therapy. Three phase III randomized control studies have demonstrated excellent positive effects of maintenance Rev -2 after HDM-ASCT and the third after primary therapy with MPR (melphalan predinisone and Rev) in transplant ineligible patients. However, in each of these a small yet measurable increase in second primary malignancies was noted within the first two years. SPMs post-HDM-ASCT has been established for decades- so this is not a new concept, but was not altogether expected with Rev maintenance.

In contrast to the studies referenced above, the use of Rev outside the context of melphalan has not been linked to SPMs. So it is unlikely the your case is Rev-induced (though nothing is impossible). It should also be noted that myeloma may co-exist with other cancers- two or even three cancers simultaneously. It is rare, but does happen. They may not be diagnosed at the same time- as is likely what has happened in your case. I have many patients with co-existent or previously diagnosed cancers and/or heme malignancies (thyroid, melanoma, lymphoma, CLL, breast, colorectal, MDS, AML, neuroendocrine tumor/carcinoid, bladder.....).

I would not be concerned about restarting Rev in this setting. However, that decision will be between you and your treating Oncologist. Best of luck

[Riza43]

Re: Revlimid secondary cancers

by Riza43 on Sat Aug 17, 2013 8:57 pm

Thank you Dr. Shain for your input.

I don't think Revlimid will be an option for me again because I did not have the nausea issue that eventually presented as the appendix problem until 3 to 4 months into my treatment. My resistance band numbers had dropped and flattened out by then. At the time I couldn't figure out why each month gave me more nausea until when only a week into my 6th course I had to have the appendectomy.

Since then, in two years none of the markers have shown up in blood or urine. It is not something I will chance again. I was lucky in that the tumor was on the neck of the appendix and was closing it off and there was no trace on any other organs. This was checked by many scans-including a scan with isotopes...

I have to say that I realize now that I was very much the novice when it came to really understanding what was going on. I didn't even know what I didn't know...I will be able to give much more input this time around.

Again...thank you...Ranetta