title: Lenalidomide treatment for multiple myeloma: systematic review and meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  In recent years, a number of randomized controlled trials (RCTs) have reported on lenalidomide as a treatment for multiple myeloma (MM). Herein, we report results of a meta-analysis of RCTs examining the efficacy and safety of lenalidomide for MM.
  
  
  METHODS
  Databases were searched using the terms "lenalidomide or revlimid AND multiple myeloma."RCTs evaluating initial or maintenance therapeutic outcomes were included. Main outcome measures were response rates, progression-free survival (PFS), overall survival, and adverse events.
  
  
  RESULTS
  Seven trials were included (N = 192-614 participants). Lenalidomide doses and treatment regimens differed between trials. Complete response (CR) and very good partial response (VGPR) risk ratios (RR) favored lenalidomide over placebo (CR = 2.54, 95% confidence interval [CI] = 1.29-5.02; VGPR = 2.82, 95% CI = 1.30-6.09). The PFS hazard ratio favored lenalidomide over placebo (0.37, 95% CI = 0.33-0.41). For adverse events, neutropenia, deep vein thrombosis (DVT), infection, and hematologic cancer RR favored placebo over lenalidomide (neutropenia: 4.74, 95% CI = 2.96-7.57; DVT: 2.52; 95% CI: 1.60-3.98; infection: 1.98; 95% CI: 1.50-2.62; hematologic cancer: 3.20; 95% CI: 1.28-7.98).
  
  
  CONCLUSIONS
  Lenalidomide is an effective treatment for MM; however, treatment-related adverse events must be considered and appropriate adjustments and/or prophylactic treatment should be initiated where possible.
authors.affiliation: Department of Geriatric Hematology, Chinese PLA General Hospital, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.forename: Rui-li
authors.initials: RL
authors.lastname: Yu
authors.forename: Xiao-hua
authors.initials: XH
authors.lastname: Chi
authors.forename: Xue-chun
authors.initials: XC
authors.lastname: Lu
mesh_terms: D018572:Disease-Free Survival; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D016609:Neoplasms, Second Primary; D016032:Randomized Controlled Trials as Topic / Q000379:methods*; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D000077269:Lenalidomide