Significantly improved overall survival can be experienced with lenalidomide plus low-dose dexamethasone therapy compared to lenalidomide plus high-dose dexamethasone, as per results of Eastern Cooperative Oncology Group Phase III clinical trial E4A03 for multiple myeloma.

The finding was reported by S. Vincent Rajkumar, M.D. at the American Society of Hematology’s annual meeting. Currently, lenalidomide and high-dose dexamethasone, referred to as Rev/Dex, is considered as the second-line treatment for myeloma.

From Sciencedaily.com:

“The standard treatment for myeloma usually includes high doses of steroids such as dexamethasone. In this study we were hoping to find that a lower dose of steroids would be just as effective,” says Dr. Rajkumar, Mayo Clinic Cancer Center hematologist and lead investigator of the study. “We were surprised to find that the regimen with high-dose steroids actually was decreasing survival, besides contributing to increased side effects.”

The study compared combination treatment of oral medications lenalidomide (a novel chemotherapeutic agent) and either high- or low-dose dexamethasone (a potent steroid effective against myeloma) in 445 patients with newly diagnosed myeloma. Lenalidomide plus high-dose dexamethasone had an 18-month survival rate of 80 percent. The comparative therapy using low-dose dexamethasone showed a significantly higher 91 percent overall survival rate at 18 months, with much less toxicity.

It was remarked by Dr. Rajkumar that this finding would be a major advance to treat cancer along with providing a new direction to the researchers for exploring that more is not necessarily better.