A study looking at lenalidomide and dexamethasone for myeloma in older people

Cancer type:

Blood cancers

Myeloma

Status:

Results

Phase:

Phase 3

This trial looked at a drug called lenalidomide and the steroid drug dexamethasone for older people with myeloma. Some younger people who couldn’t have a stem cell transplant Open a glossary item were also able to take part.

More about this trial

In the past, most doctors usually treated myeloma in older people with chemotherapy and steroids Open a glossary item . One of the usual treatment combinations is called MPT.

MPT is the chemotherapy drug melphalan, the steroid drug prednisolone and a type of targeted drug called thalidomide. But sometimes this treatment stops working or the myeloma comes back. So doctors wanted to improve treatment for this group of people.

In this trial, researchers looked at a drug called lenalidomide and the steroid drug dexamethasone. Lenalidomide is a type of targeted drug.

The trial compared usual MPT treatment with lenalidomide and dexamethasone. The aims of the trial were to

Find out which treatment controls the myeloma for longer
Learn more about the side effects

Summary of results

The trial team found that lenalidomide and dexamethasone worked for older people with myeloma and younger people who couldn’t have a stem cell transplant.

These results were published in 2018.

Results
1, 623 people took part in this trial.

535 had lenalidomide and dexamethasone for as long as treatment was helping them (doctors call this continuous treatment)
541 had lenalidomide and dexamethasone for up to 18 months
547 had usual MPT treatment for up to 18 months

The researchers looked at the average length of time people lived without any signs of the myeloma getting worse. Researchers call this progression free survival. This was

Just over 2 years for people having continuous lenalidomide and dexamethasone
Just under 21 months for people having lenalidomide and dexamethasone for up to 18 months
Just over 20 months for people having MPT

At 5 ½ years, the researchers looked at the average length of time people lived for. This was about:

59 months in the continuous lenalidomide group (group 1)
62 months in the lenalidomide and dexamethasone group (group 2)
49 months in the MPT group (group 3)

Study bar chart - average length of time people lived for

At the 6 year follow up, 52 people in the continuous lenalidomide group were still having treatment.

Side effects
People in the MPT group had more problems with a drop in blood cells. People having continuous lenalidomide had more infections than the other 2 groups.

The trial team found that continuous lenalidomide and dexamethasone was a useful treatment for myeloma in older people or younger people who couldn’t have a stem cell transplant. They concluded that continuous lenalidomide increased the length of time before myeloma got worse and improved overall survival for these groups of people.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the research team. We have not analysed the data ourselves.