Second malignancies in the context of lenalidomide treatment: an analysis of 2732 myeloma patients enrolled to the Myeloma XI trial.
View/ Open
Date
2016-12-09Author
Jones, JR
Cairns, DA
Gregory, WM
Collett, C
Pawlyn, C
Sigsworth, R
Striha, A
Henderson, R
Kaiser, MF
Jenner, M
Cook, G
Russell, NH
Williams, C
Pratt, G
Kishore, B
Lindsay, J
Drayson, MT
Davies, FE
Boyd, KD
Owen, RG
Jackson, GH
Morgan, GJ
Type
Journal Article
Metadata
Show full item recordAbstract
We have carried out the largest randomised trial to date of newly diagnosed myeloma patients, in which lenalidomide has been used as an induction and maintenance treatment option and here report its impact on second primary malignancy (SPM) incidence and pathology. After review, 104 SPMs were confirmed in 96 of 2732 trial patients. The cumulative incidence of SPM was 0.7% (95% confidence interval (CI) 0.4-1.0%), 2.3% (95% CI 1.6-2.7%) and 3.8% (95% CI 2.9-4.6%) at 1, 2 and 3 years, respectively. Patients receiving maintenance lenalidomide had a significantly higher SPM incidence overall (P=0.011). Age is a risk factor with the highest SPM incidence observed in transplant non-eligible patients aged >74 years receiving lenalidomide maintenance. The 3-year cumulative incidence in this group was 17.3% (95% CI 8.2-26.4%), compared with 6.5% (95% CI 0.2-12.9%) in observation only patients (P=0.049). There was a low overall incidence of haematological SPM (0.5%). The higher SPM incidence in patients receiving lenalidomide maintenance therapy, especially in advanced age, warrants ongoing monitoring although the benefit on survival is likely to outweigh risk.
Collections
Subject
Humans
Multiple Myeloma
Neoplasms, Second Primary
Hydroxamic Acids
Thalidomide
Oligopeptides
Antineoplastic Combined Chemotherapy Protocols
Disease-Free Survival
Risk Factors
Adult
Aged
Aged, 80 and over
Middle Aged
Female
Male
Kaplan-Meier Estimate
Bortezomib
Lenalidomide
Vorinostat
Research team
Myeloma Biology and Therapeutics
Myeloma Group
Language
eng
Date accepted
2016-10-24
License start date
2016-12-09
Citation
Blood cancer journal, 2016, 6 (12), pp. e506 - ?
Publisher
NATURE PUBLISHING GROUP