Lenalidomide induces complete and partial remissions in patients with relapsed and refractory chronic lymphocytic leukemia.
This study investigated the activity of lenalidomide in patients with relapsed/refractory chronic lymphocytic leukemia (CLL). Lenalidomide was given at 10 mg daily with dose escalation up to 25 mg daily. Three patients (7%) achieved a complete response (CR), one a nodular partial remission, and 10 patients a partial remission (PR), for an overall response (OR) rate of 32%. Treatment with lenalidomide was associated with an OR rate of 31% in patients with 11q or 17p deletion, of 24% in patients with unmutated V(H), and of 25% in patients with fludarabine-refractory disease. The most common toxicity was myelosuppression, and the median daily dose of lenalidomide tolerated was 10 mg. Plasma levels of angiogenic factors, inflammatory cytokines, and cytokine receptors were measured at baseline, day 7, and day 28. There was a dramatic increase in median interleukin (IL)-6, IL-10, IL-2, and tumor necrosis factor receptor-1 levels on day 7, whereas no changes were observed in median vascular endothelial growth factor levels (20 patients studied). According to our experience, lenalidomide given as a continuous treatment has antitumor activity in heavily pretreated patients with CLL.
Ferrajoli
Alessandra
A
Department of Leukemia, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77230-1402, USA. aferrajo@mdanderson.org
Lee
Bang-Ning
BN
Schlette
Ellen J
EJ
O'Brien
Susan M
SM
Gao
Hui
H
Wen
Sijin
S
Wierda
William G
WG
Estrov
Zeev
Z
Faderl
Stefan
S
Cohen
Evan N
EN
Li
Changping
C
Reuben
James M
JM
Keating
Michael J
MJ
D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001853:Bone Marrow / Q000098:blood supply / Q000187:drug effects; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D000077269:Lenalidomide; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D011379:Prognosis; D012074:Remission Induction; D013601:T-Lymphocytes / Q000187:drug effects; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
D000970:Antineoplastic Agents; D016207:Cytokines; D013792:Thalidomide; D000077269:Lenalidomide