title: Previous thalidomide therapy may not affect lenalidomide response and outcome in relapse or refractory multiple myeloma patients.
abstract: BACKGROUND
  Lenalidomide is a thalidomide analogue, designed to have improved efficacy and tolerability over the parent drug. The aim of this retrospective analysis is to evaluate the impact of thalidomide therapy on lenalidomide response and outcome in relapse or refractory multiple myeloma patients.
  
  
  METHODS
  A total of 106 relapsed or refractory multiple myeloma patients received lenalidomide 25mg plus dexamethasone as salvage therapy; 80 patients progressed on thalidomide treatment (thalidomide-resistant) and 26 patients discontinued thalidomide in at least partial remission (thalidomide-sensitive). Median time from diagnosis to lenalidomide treatment was 57 months. Median prior lines of therapies were 3, range 1-6. 62% of patients were previously treated with autologous stem cell transplantation, and 71% with bortezomib-based regimens.
  
  
  RESULTS
  In the thalidomide-resistant and -sensitive groups, the at least partial response rates were 56.2% and 61.5% (P = .45), including at least VGPR rates of 16.2% and 11.5%; the median progression free survival was 10 and 12 months (P=.12) and the median overall survival was 17 and 18.5 months (P = .50), respectively.
  
  
  CONCLUSIONS
  Lenalidomide may be equally effective in heavily pre-treated multiple myeloma patients who are thalidomide-resistant or thalidomide-sensitive to a previous therapy.
authors.affiliation: Department of Clinical and Biological Sciences, University of Turin and San Luigi Hospital, Orbassano, Turin, Italy. tguglielmelli@libero.it
authors.forename: T
authors.initials: T
authors.lastname: Guglielmelli
authors.forename: S
authors.initials: S
authors.lastname: Bringhen
authors.forename: S
authors.initials: S
authors.lastname: Rrodhe
authors.forename: F
authors.initials: F
authors.lastname: Gay
authors.forename: F
authors.initials: F
authors.lastname: Cavallo
authors.forename: A
authors.initials: A
authors.lastname: Berruti
authors.forename: V
authors.initials: V
authors.lastname: Montefusco
authors.forename: E
authors.initials: E
authors.lastname: Piro
authors.forename: G
authors.initials: G
authors.lastname: Benevolo
authors.forename: M T
authors.initials: MT
authors.lastname: Petrucci
authors.forename: T
authors.initials: T
authors.lastname: Caravita
authors.forename: M
authors.initials: M
authors.lastname: Offidani
authors.forename: P
authors.initials: P
authors.lastname: Corradini
authors.forename: M
authors.initials: M
authors.lastname: Boccadoro
authors.forename: G
authors.initials: G
authors.lastname: Saglio
authors.forename: A
authors.initials: A
authors.lastname: Palumbo
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D003907:Dexamethasone / Q000008:administration & dosage; D004347:Drug Interactions; D019008:Drug Resistance, Neoplasm; D006801:Humans; D000077269:Lenalidomide; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide