Multiple myeloma patients who continued Revlimid treatment after achieving at least a partial response experienced significantly higher overall survival compared to patients who discontinued treatment, according to a recent study published in the journal Clinical Lymphoma, Myeloma, & Leukemia.

However, the study authors noted that proper management of side effects is necessary for patients to achieve the survival benefit.

Two previous Phase 3 trials showed that Revlimid (lenalidomide) plus dexamethasone (Decadron) improved overall survival more than dexamethasone alone in patients with relapsed or refractory (resistant) myeloma (38.0 months versus 31.6 months). The results also showed that patients who achieved a complete or very good partial response had better overall survival than patients who achieved a partial response.

In a follow-up analysis, researchers retrospectively analyzed data of 212 relapsed/refractory myeloma patients from the two previous Phase 3 trials who had achieved at least a partial response to determine the effects of continued Revlimid plus dexamethasone treatment on overall survival.

Of the 212 patients who had achieved at least a partial response, 174 continued treatment until disease progression and 38 discontinued treatment early, primarily due to side effects or withdrawal of consent. The patients who continued treatment were, on average, younger and had less advanced disease.

After a median follow-up of 48.6 months, 108 of the 174 patients (62 percent) were still receiving treatment, and 66 patients (38 percent) had discontinued treatment due to disease progression.

Of the 108 patients who continued treatment for four years, 56 percent achieved a complete response or a very good partial response as best response, whereas the majority of patients who had discontinued treatment (82 percent) achieved a partial response as best response.

The researchers found that the median overall survival was significantly higher in patients who continued treatment compared to patients who discontinued early for reasons other than disease progression (50.9 months versus 35.0 months).

Despite the significant survival benefit, 80 percent of patients who continued treatment experienced at least one serious or life-threatening side effect.

The most common serious or life-threatening side effects included low white blood cell count (41 percent), low platelet count (12 percent), and low red blood cell count (8 percent).

Approximately 11 percent of patients also experienced blood clots.  The researchers recommended preventative treatment with blood thinners, such as warfarin (Coumadin) or aspirin, to minimize the frequency of blood clots.

For more information, please refer to the article in the journal Clinical Lymphoma, Myeloma, & Leukemia (abstract).