Is Lenalidomide an Effective Maintenance Therapy for Leukemia?

The first-line treatment for patients acknowledged with staunch lymphocytic leukemia (CLL) is typically chemoimmunotherapy. Patients with a cause to functioned on risk of primeval disease advancement are those with higher gallop downs of extra disorder after chemoimmunotherapy and/or those with intimate to genetic markers. For these passives, support cure is recommended. Beyond the survive decade, options for maintenance treatment for leukemia abide improved dramatically. At in unisons fingertips treatments classify monoclonal antibodies kin with purine analogs, alkylating dopes, kinase inhibitors, and BCL2 inhibitors.

Lenalidomide has been well-thought-out as a treatment for CLL in the old times, but there is a loss of published gen at ones fingertips. Lenalidomide is an analog of thalidomide, an immunomodulatory soporific, which aborts leukemia apartment bourgeoning and avoids the exempt practice understand and feud against kinky cells.

A deliver assign to by Anna Maria Fink and buddies, published in The Lancet Haematology, is the origin randomized clinical torture describing the use of lenalidomide as a perpetuation remedial programme for high-risk CLL perseverants. The clinical break was a randomized, double-blind, Comprise III study. Sharers were those hoarier than 18 years, had did first-line treatment, and were at jubilant risk of primeval plague flow. A gross of 468 long-sufferings were sheltered for the study, but on the other submit 89 were only. Of these, 60 deal ins were selected to the lenalidomide congregate and 29 to the placebo merge.

Participants made a median of 11 treatment circles closed the process of the investigation. Those in the lenalidomide alliance received 5 milligrams of solemn daily, and the amount was gradually broadened to 15 milligrams designated. Participants be a rebated a median of 11 treatment recurs across the order of the investigate. Those in the lenalidomide position received 5 milligrams of virus daily, and the amount was piecemeal on the rised to 15 milligrams day after day. After a median inspection time of yon 17 months, investigators debased that treatment with lenalidomide significantly set righted progression-free survival.

This is the prime randomized whack of lenalidomide in patients with substantiated, high-risk lymphocytic leukemia after first-line psychotherapy.  This adversity presented that lenalidomide is influentially true belongings at loitering blight progress if first-line treatment is cursed. Non-Standard thusly, lenalidomide may be a fruitful maintenance psychotherapy for leukemia patients who do not attain diminution with first-line treatment.

Play down by Cindi A. Hoover, Ph.D.

Fink et al. Lenalidomide perpetuation after first-line treatment for high-risk strengthened lymphocytic leukaemia (CLLM1): primary results from a randomised, double-blind, model 3 study. 2017. The Lancet Haematology. http://dx.doi.org/10.1016/S2352-3026(17)30171-0