%0 Journal Article
%T Lenalidomide and dexamethasone in patients with relapsed multiple myeloma and impaired renal function: PrE1003, a PrECOG study
%J -
%D 2018
%R https://doi.org/10.1038/s41408-018-0110-7
%X Renal insufficiency is common in patients with relapsed multiple myeloma and can often limit choice of therapy. Lenalidomide, a critical agent in the treatment of relapsed multiple myeloma, is renally cleared., This phase I/II trial evaluated the efficacy and safety of lenalidomide with dexamethasone in patients with relapsed multiple myeloma and renal insufficiency. Three groups were treated, with creatinine clearance 30¨C60£¿cc/hr (group A), CrCl£¿<£¿30 not on dialysis (group B), and patients on dialysis (group C) at escalating doses of lenalidomide. A total of 63 patients were treated and no DLTs were observed in phase I. All three groups were able to escalate to full dose lenalidomide 25£¿mg daily 21/28 days, although due to reduced accrual the phase II component was not entirely completed for groups B and C. Adverse events were as expected, including anemia, diarrhea and fatigue. Ten patients experienced grade 3¨C4 pneumonia. Overall response rate was 54% across all groups. PFS was 7.5 months and OS was 19.7 months. Lenalidomide can be given at full dose 25£¿mg daily 21/28 in patients with a CrCl£¿>£¿30, and can be given daily to those with CrCl£¿<£¿30, even when on dialysis, at doses of at least 15£¿mg daily
%U https://www.nature.com/articles/s41408-018-0110-7