Lenalidomide after Stem-Cell Transplantation for Multiple Myeloma

SUMMARY: REVLIMID® (Lenalidomide) is an immunomodulatory agent with significant activity in patients with Multiple Myeloma, by virtue of its multiple mechanisms of action. In two, double blind, randomized, phase III trials, patients with stable disease following stem cell transplantation, were randomized to receive either REVLIMID® (Lenalidomide) or placebo maintenance, until progression. In both these studies there was a statistically significant improvement in the progression free survival or time to progression in the patient group receiving REVLIMID® maintenance. This benefit was independent of response to initial induction therapy at the time of randomization and other patient characteristics such as B2 microglobulin, cytogenetics or exposure to lenalidomide or thalidomide during induction. There was however a slightly higher incidence of second primary malignancies in the REVLIMID® group compared to the placebo group (8% vs 4%). We have come a long way, controlling this disease and maintenance REVLIMID® has paved the way, changing Multiple Myeloma into a chronic disease. McCarthy PL, Owzar K, Hofmeister CC, et al. N Engl J Med 2012;366:1770-1781 and Attal M, Lauwers-Cances V, Marit G, et al. N Engl J Med 2012;366:1782-1791