文章：

标准剂量与低剂量来那度胺难治性多发性骨髓瘤患者的结局

Outcomes of patients with multiple myeloma refractory to standard dose vs low dose lenalidomide

原文发布日期：2024-03-26

DOI: 10.1038/s41408-024-01039-1

类型: Article

开放获取: 是

英文摘要：

Refractoriness to lenalidomide is an important factor determining the choice of therapy at first relapse in multiple myeloma (MM). It remains debatable if resistance to lenalidomide varies among MM refractory to standard doses vs low dose maintenance doses. In this study, we assessed the outcomes with subsequent therapies in patients with MM refractory to standard dose vs low dose lenalidomide. We retrospectively reviewed all patients with MM at our institution who received first line therapy with lenalidomide containing regimens, and assessed progression free survival (PFS) and overall survival for these patients for second line therapy, and with lenalidomide retreatment. For second line therapy, we found no difference in the PFS between standard dose refractory and low dose refractory groups (median PFS 14 months vs 14 months, p = 0.95), while the PFS for both these groups was inferior to the not refractory group (median PFS 30 months, p < 0.001 for both pairs). Similar trends were seen among these groups on lenalidomide retreatment, and on multivariable analysis. These data suggest that refractoriness to lenalidomide is not dose dependent, and definition of lenalidomide refractoriness should not depend on the dose of lenalidomide to which the disease was considered refractory.
 

摘要翻译： 

来那度胺耐药性是决定多发性骨髓瘤首次复发时治疗方案选择的重要因素。对于标准剂量治疗与低剂量维持治疗无效的患者，其对来那度胺的耐药性是否存在差异仍存争议。本研究评估了标准剂量与低剂量来那度胺治疗无效的多发性骨髓瘤患者接受后续治疗的效果。我们回顾性分析了本机构所有接受含来那度胺方案一线治疗的多发性骨髓瘤患者，评估这些患者接受二线治疗及来那度胺再治疗时的无进展生存期和总生存期。在二线治疗中，标准剂量耐药组与低剂量耐药组的无进展生存期无显著差异（中位无进展生存期均为14个月，p=0.95），而这两组的无进展生存期均显著低于非耐药组（中位无进展生存期30个月，两组比较p<0.001）。在来那度胺再治疗及多变量分析中，这些组别也呈现相似趋势。这些数据表明，对来那度胺的耐药性不具有剂量依赖性，来那度胺耐药的定义不应取决于疾病发生耐药时所对应的药物剂量。

原文链接：

Outcomes of patients with multiple myeloma refractory to standard dose vs low dose lenalidomide