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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Vij, Ravi Callander, Natalie Scott Gabriel, Don A. Hars, Vera Mcclune, Brian Anderson, Kenneth C. Schlossman, Robert Bressler, Linda Rosenbaum, Cara Owzar, Kouros Hari, Parameswaran Linker, Charles Bashey, Asad Bennett, Elizabeth Pasquini, Marcelo C. Landau, Heather Hassoun, Hani Devine, Steven M. Giralt, Sergio Seiler, Michele Hofmeister, Craig C. Stadtmauer, Edward A. Horowitz, Mary M. Gentile, Teresa Van Besien, Koen Richardson, Paul G. Shea, Thomas C. Martin, Thomas Maziarz, Richard T. Qazilbash, Muzaffar H. Mccarthy, Philip L. Hurd, David D. Barry, Susan Isola, Luis Jiang, Chen Weisdorf, Daniel J. Moreb, Jan S. Kelly, Michael Levitan, Denise Postiglione, John |
| Description | Author Affiliation: McCarthy PL ( Blood and Marrow Transplant Program, Roswell Park Cancer Institute, Buffalo, NY 14263, USA. philip.mccarthy@roswellpark.org) |
| Abstract | BACKGROUND: Data are lacking on whether lenalidomide maintenance therapy prolongs the time to disease progression after autologous hematopoietic stem-cell transplantation in patients with multiple myeloma. METHODS: Between April 2005 and July 2009, we randomly assigned 460 patients who were younger than 71 years of age and had stable disease or a marginal, partial, or complete response 100 days after undergoing stem-cell transplantation to lenalidomide or placebo, which was administered until disease progression. The starting dose of lenalidomide was 10 mg per day (range, 5 to 15). RESULTS: The study-drug assignments were unblinded in 2009, when a planned interim analysis showed a significantly longer time to disease progression in the lenalidomide group. At unblinding, 20% of patients who received lenalidomide and 44% of patients who received placebo had progressive disease or had died (P<0.001); of the remaining 128 patients who received placebo and who did not have progressive disease, 86 crossed over to lenalidomide. At a median follow-up of 34 months, 86 of 231 patients who received lenalidomide (37%) and 132 of 229 patients who received placebo (58%) had disease progression or had died. The median time to progression was 46 months in the lenalidomide group and 27 months in the placebo group (P<0.001). A total of 35 patients who received lenalidomide (15%) and 53 patients who received placebo (23%) died (P=0.03). More grade 3 or 4 hematologic adverse events and grade 3 nonhematologic adverse events occurred in patients who received lenalidomide (P<0.001 for both comparisons). Second primary cancers occurred in 18 patients who received lenalidomide (8%) and 6 patients who received placebo (3%). CONCLUSIONS: Lenalidomide maintenance therapy, initiated at day 100 after hematopoietic stem-cell transplantation, was associated with more toxicity and second cancers but a significantly longer time to disease progression and significantly improved overall survival among patients with myeloma. (Funded by the National Cancer Institute; ClinicalTrials.gov number, NCT00114101.). |
| ISSN | 00284793 |
| e-ISSN | 15334406 |
| Journal | New England Journal of Medicine |
| Issue Number | 19 |
| Volume Number | 366 |
| Language | English |
| Publisher | Massachusetts Medical Society (United States) |
| Publisher Date | 2012-05-10 |
| Publisher Place | United States |
| Access Restriction | Open |
| Subject Keyword | Antineoplastic Agents Therapeutic Use Multiple Myeloma Drug Therapy Stem Cell Transplantation Thalidomide Analogs & Derivatives Adverse Effects Disease-Free Survival Double-Blind Method Follow-Up Studies Maintenance Chemotherapy Mortality Therapy Neoplasms, Second Primary Epidemiology Clinical Trial, Phase III Multicenter Study Randomized Controlled Trial Research Support, N.I.H., Extramural Medicine |
| Content Type | Text |
| Resource Type | Article |
| Subject | Medicine |
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