Continuous treatment with lenalidomide and low‐dose dexamethasone in transplant‐ineligible patients with newly diagnosed multiple myeloma in Asia: subanalysis of the FIRST trial
2017
Summary The phase 3 FIRST (Frontline Investigation of REVLIMID + Dexamethasone Versus Standard
Thalidomide) trial demonstrated that
lenalidomideplus 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
continuouslyor 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
continuousin 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
continuousversus MPT and by 35% with Rd
continuousversus Rd18. Rd
continuousimproved 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
continuousand 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
continuousis safe and effective in transplant-ineligible Asian patients with NDMM.
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