LENALIDOMIDE vs. THALIDOMIDE FOR MYELOFIBROSIS

Blood. 2011 May 26. [Epub ahead of print]

Comparison of thalidomide and lenalidomide as therapy for myelofibrosis.

Jabbour E, Thomas D, Kantarjian H, Zhou L, Pierce S, Cortes J, Verstovsek S.

Source

Department of Leukemia, U.T. M.D. Anderson Cancer Center, Houston, TX, United States.

Abstract

Using the IWG-MRT consensus criteria, we re-assessed the efficacy of thalidomide and lenalidomide in 125 patients with myelofibrosis treated in 3 consecutive phase II trials: 44 received single-agent thalidomide; 41 single-agent lenalidomide; and 40 a combination of lenalidomide+prednisone. Thalidomide group included significantly more untreated patients and patients with performance status of 2. Lenalidomide-based therapy produced higher efficacy (34-38%) than thalidomide (16%; p=0.06). Responses to thalidomide were seen within 3-15 weeks, while responses to lenalidomide-based therapy were also seen after prolonged course of therapy (range 2-45 weeks). Lenalidomide+prednisone therapy resulted in significantly longer response duration (median 34 months) than single-agent lenalidomide or thalidomide (median 7 and 13 months, respectively; p=0.042). Fewer patients (p=0.001) discontinued lenalidomide+prednisone therapy (13%) due to side effects then patients on single-agents therapy (32-39%). In conclusion, the combination of lenalidomide+prednisone appears to be more effective and safer than single-agent thalidomide or lenalidomide.