title: Continuous treatment with lenalidomide and low-dose dexamethasone in transplant-ineligible patients with newly diagnosed multiple myeloma in Asia: subanalysis of the FIRST trial.
abstract: The phase 3 FIRST (Frontline Investigation of REVLIMID + Dexamethasone Versus Standard Thalidomide) trial demonstrated that lenalidomide plus low-dose dexamethasone (Rd) until disease progression (Rd continuous) is an effective treatment option for transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). Given genetic differences between Asian and Western populations, this subanalysis of the FIRST trial examined the safety and efficacy of Rd (given continuously or for 18 cycles [Rd18]) and MPT (melphalan, prednisone, thalidomide) in 114 Asian patients from Mainland China, South Korea and Taiwan. Efficacy and safety with Rd continuous in Asian patients were consistent with those in the overall study population. The overall response rates were 77·8% for Rd continuous, 57·5% for MPT and 65·8% for Rd18. The risk of progression or death was reduced by 39% with Rd continuous versus MPT and by 35% with Rd continuous versus Rd18. Rd continuous improved the 3-year survival rate compared with MPT (70·2% vs. 56·4%) and Rd18 (58·1%). Common grade 3/4 adverse events in the Rd continuous and MPT arms were neutropenia (25·0% vs. 43·6%), infection (19·4% vs. 28·2%) and anaemia (19·4% vs. 15·4%), respectively. Thromboembolic event rates were low, and no second primary malignancies were observed. Rd continuous is safe and effective in transplant-ineligible Asian patients with NDMM.
authors.affiliation: Peking University People's Hospital, Beijing, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Lu
authors.affiliation: Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Jae H
authors.initials: JH
authors.lastname: Lee
authors.affiliation: National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Shang-Yi
authors.initials: SY
authors.lastname: Huang
authors.affiliation: Institute of Haematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China.
authors.forename: Lugui
authors.initials: L
authors.lastname: Qiu
authors.affiliation: Chonnam National University Hwasun Hospital, Hwasun-gun, Jeonnam, Korea.
authors.forename: Je-Jung
authors.initials: JJ
authors.lastname: Lee
authors.affiliation: West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Liu
authors.affiliation: Seoul National University Hospital, Seoul, Korea.
authors.forename: Sung-Soo
authors.initials: SS
authors.lastname: Yoon
authors.affiliation: Sungkyunkwan University, Samsung Medical Centre, Seoul, Korea.
authors.forename: Kihyun
authors.initials: K
authors.lastname: Kim
authors.affiliation: Ruijin Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Zhi X
authors.initials: ZX
authors.lastname: Shen
authors.affiliation: National Cancer Centre, Gyeonggi-do, Korea.
authors.forename: Hyeon S
authors.initials: HS
authors.lastname: Eom
authors.affiliation: Beijing Chao-Yang Hospital, Beijing, China.
authors.forename: Wen M
authors.initials: WM
authors.lastname: Chen
authors.affiliation: The Catholic University of Korea, Seoul, Korea.
authors.forename: Chang K
authors.initials: CK
authors.lastname: Min
authors.affiliation: Hallym University Sacred Heart Hospital, Anyang, Korea.
authors.forename: Hyo J
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Seoul National University Bundang Hospital, Seongnam, Korea.
authors.forename: Jeong O
authors.initials: JO
authors.lastname: Lee
authors.affiliation: Chonbuk National University Hospital, Jeonju, Korea.
authors.forename: Jae Y
authors.initials: JY
authors.lastname: Kwak
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Wai
authors.initials: W
authors.lastname: Yiu
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Guang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Celgene Corporation, Summit, NJ, USA.
authors.forename: Annette
authors.initials: A
authors.lastname: Ervin-Haynes
authors.affiliation: Hospital University Centre (CHU), Bordeaux, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Hulin
authors.affiliation: Service des Maladies du Sang, Hôpital Claude Huriez, Lille, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Facon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000139:chemically induced; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001208:Asia; D044466:Asian People; D003907:Dexamethasone / Q000008:administration & dosage*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007239:Infections / Q000139:chemically induced; D000077269:Lenalidomide; D008297:Male; D008558:Melphalan / Q000627:therapeutic use; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D009503:Neutropenia / Q000139:chemically induced; D011241:Prednisone / Q000627:therapeutic use; D012074:Remission Induction; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide; D003907:Dexamethasone; D000077269:Lenalidomide; D008558:Melphalan; D011241:Prednisone
keywords: Asia; lenalidomide; multiple myeloma; newly diagnosed; transplant-ineligible