Secondary Cancer Risks of Lenalidomide for Newly Diagnosed Myeloma Patients

Lenalidomide has been linked to secondary cancers in myeloma. A study was just published by Dr. Antonio Palumbo, MD of Italian Multiple Myeloma Study Group and many other myeloma experts that described research to compare the incidence of secondary cancers in patients with and without lenalidomide exposure. Looking back to studies already completed for newly diagnosed patients (in nine past trials involving 3218 treated patients), 2620 had been treated with lenalidomide and 598 had not. At five years, 6.9% of patients who had received lenalidomide had acquired a secondary cancer while 4.8% of patients who had not received lenalidomide had acquired a secondary cancer. To break down the types of secondary cancers developed, the study took the data one step further. After five years, solid tumor cancers were found in  3.8%  of patients receiving lenalidomide and in 3.4% of patients who did not. In the same time frame, secondary hematological cancers were found in 3.1% of patients receiving lenalidomide while these same types of secondary cancers were found in 1.4% of patients not receiving the drug. Those who had lenalidomide in combination with oral melphalan had significantly increased hematological secondary cancers while those who received lenalidomide/cyclophosphamide or lenalidomide/dexamathasone did not. The study recommends that patients with newly diagnosed myeloma should use alternatives like cyclophosphamide or alkylating-free combinations instead of oral melphalan when lenalidomide is used. Read the article in Lancet Oncology