Significantly better survival rate is possible with a combination of lenalidomide and low-dose dexamethasone therapy when compared to a combination of lenalidomide plus high-dose dexamethasone.
This finding was reported by S. Vincent Rajkumar, M.D. at the American Society of Hematology’s annual meeting while revealing results of Eastern Cooperative Oncology Group Phase III clinical trial E4A03, for multiple myeloma.
From News-Medical.Net:
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.
“The lower survival rates with the high-dose dexamethasone can be attributed to disease progression as well as treatment-related toxicities,” says Dr. Rajkumar. “This is a major advance in the treatment of this cancer, and also gives researchers a new direction to explore — that more is not necessarily better.”
Dr. Rajkumar, Mayo Clinic Cancer Center hematologist and lead investigator of the study, said that it was surprising to know that high doses of steroids actually reduced survival and increased side effects.
