Low-dose Dexamethasone plus Revlimid® Improves Survival in Multiple Myeloma

Low-dose Dexamethasone plus Revlimid® Improves Survival in Multiple Myeloma over High-dose Dexamethasone

According to results recently reported in a press release by Celgene, treatment with low-dose dexamethasone (Decadron®) plus Revlimid® (lenalidomide) significantly improves survival compared with high-dose dexamethasone plus Revlimid in patients with multiple myeloma.

Multiple myeloma is a cancer of the blood that affects the plasma cells. Plasma cells are an important part of the immune system; they produce antibodies to help fight infection and disease. Multiple myeloma is characterized by an excess production of abnormal plasma cells. Symptoms include increased risk of bacterial infections and impaired immune responses.

Revlimid, an immunomodulatory agent, fights cancer through several biological mechanisms, many of which are still being evaluated. One action Revlimid uses against cancer is to prevent or reduce blood vessel growth to the cancer. This ultimately starves the cancer cells of nutrients and oxygen. Revlimid continues to be evaluated in clinical trials for various types of cancers. Revlimid is typically used in combination with the steroid dexamethasone; one concern about this combination is that high doses of dexamethasone are associated with an increased risk of thrombotic events (blood clots).

Researchers affiliated with the Eastern Cooperative Oncology Group (ECOG) recently conducted a clinical trial referred to as E4A03 in which Revlimid plus high-dose dexamethasone was compared to Revlimid plus a low-dose of dexamethasone as initial therapy for multiple myeloma. Preliminary results from this trial have recently been presented by the Data Monitoring Committee review.

  • Patients treated with Revlimid and low-dose dexamethasone had an improved survival compared to those treated with high-dose dexamethasone and Revlimid.
  • Mature results are expected to be presented at the 2007 annual meeting of the American Society of Clinical Oncology (ASCO).

The researchers concluded that low-dose dexamethasone/Revlimid demonstrates improved survival compared with high-dose dexamethasone/Revlimid as initial therapy for multiple myeloma. Higher doses of dexamethasone are associated with increased risks of thrombotic events, potentially reducing survival for these patients. Mature analysis will reveal the true outcome of this trial.

Patients diagnosed with multiple myeloma who are treated with high doses of dexamethasone may wish to speak with their physician regarding their individual risks and benefits of specific doses of the steroid.

Reference: Celgene Corporation. ECOG Phase III newly diagnosed multiple myeloma trial (E4A03) reports lenalidomide plus low-dose dexamethasone suggests survival advantage for patients with multiple myeloma. Available at: =. Accessed April 2007.

Related News:Revlimid®/Dexamethasone Effective Initial Therapy for Multiple Myeloma (09/21/2005)

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