title: Lenalidomide in patients with chemotherapy-induced polyneuropathy and relapsed or refractory multiple myeloma: results from a single-centre prospective study.
abstract: Lenalidomide, an immunomodulatory drug used in myeloma therapy, has been claimed to be less neurotoxic than thalidomide, but evidence is still weak. We prospectively assessed lenalidomide safety in myeloma patients to evaluate whether it would induce or modify a previously ensued chemotherapy-induced peripheral neuropathy (CIPN). Thirty consecutive patients (17 men, mean age 63.7 ± 9.4) previously treated with bortezomib and/or thalidomide and starting on lenalidomide (25 mg/day for 21-day cycles) for relapsed or refractory myeloma were assessed at baseline, 6, and 12 months from the beginning of lenalidomide with Total Neuropathy Score clinical version (TNSc), Eastern Cooperative Oncology Group (ECOG) performance status, and numeric rating scale (NRS) for pain. TNSc >2 was considered significant for CIPN. TNSc changes of at least 4 points from baseline value were considered clinically relevant. At baseline 16 of the 30 patients (53.3%) had CIPN (mean TNSc 5.8, range 3-15). After 6 months, 13 patients were unchanged, 1 improved, and 2 worsened. After 12 months the patient who had improved persisted stable, and the two who had worsened returned to TNSc baseline value. The 14 patients without CIPN at baseline did not develop neuropathy. NRS and ECOG performance status persisted unchanged. Our results demonstrate lenalidomide safety and very low neurotoxicity also in patients with pre-existing CIPN treated for 1 year.
authors.affiliation: Department of Neurosciences, Neurological, Psychiatric, Sensorial, Reconstructive and Rehabilitative Sciences, University of Padova, Padova, Italy. chiara.briani@unipd.it
authors.forename: Chiara
authors.initials: C
authors.lastname: Briani
authors.forename: Chiara Dalla
authors.initials: CD
authors.lastname: Torre
authors.forename: Marta
authors.initials: M
authors.lastname: Campagnolo
authors.forename: Marta
authors.initials: M
authors.lastname: Lucchetta
authors.forename: Tamara
authors.initials: T
authors.lastname: Berno
authors.forename: Laura
authors.initials: L
authors.lastname: Candiotto
authors.forename: Luca
authors.initials: L
authors.lastname: Padua
authors.forename: Mario
authors.initials: M
authors.lastname: Ermani
authors.forename: Guido
authors.initials: G
authors.lastname: Cavaletti
authors.forename: Renato
authors.initials: R
authors.lastname: Zambello
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000139:chemically induced / Q000188:drug therapy*; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced / Q000188:drug therapy; D011115:Polyneuropathies / Q000139:chemically induced / Q000188:drug therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D000077269:Lenalidomide