Comparison of thalidomide and lenalidomide as therapy for myelofibrosis.

Abstract

With the use of the International Working Group for Myelofibrosis Treatment and Research consensus criteria, we re-assessed the efficacy of thalidomide and lenalidomide in 125 patients with myelofibrosis treated in 3 consecutive phase 2 trials: 44 received single-agent thalidomide, 41 single-agent lenalidomide, and 40 a combination of lenalidomide plus prednisone. The thalidomide group included significantly more untreated patients and patients with performance status of 2. The Lenalidomide-based therapy produced higher efficacy (34%-38%) than thalidomide (16%; P = .06). Responses to thalidomide were seen within 3-15 weeks, whereas responses to the lenalidomide-based therapy were also seen after a prolonged course of therapy (range, 2-45 weeks). Lenalidomide plus prednisone therapy resulted in significantly longer response duration (median, 34 months) than single-agent lenalidomide or thalidomide (median, 7 and 13 months, respectively; P = .042). Fewer patients (P = .001) discontinued the lenalidomide plus prednisone therapy (13%) because of side effects then patients on single-agents therapy (32%-39%). In conclusion, the combination of lenalidomide plus prednisone appears to be more effective and safer than single-agent thalidomide or lenalidomide.

• Authors: Elias Jabbour, Deborah Thomas, Hagop Kantarjian, Lingsha Zhou, Sherry Pierce, Jorge Cortes, Srdan Verstovsek
• Journal: Blood (Blood) Vol. 118 Issue 4 Pg. 899-902 (Jul 28 2011) ISSN: 1528-0020 [Electronic] United States
• PMID: 21622644 (Publication Type: Clinical Trial, Phase II, Comparative Study, Journal Article)

Chemical References

• Immunosuppressive Agents
• Thalidomide
• Lenalidomide

Topics

• Adult
• Aged
• Aged, 80 and over
• Drug Therapy, Combination
• Female
• Humans
• Immunosuppressive Agents (administration & dosage, adverse effects, therapeutic use)
• Lenalidomide
• Male
• Middle Aged
• Primary Myelofibrosis (drug therapy)
• Thalidomide (administration & dosage, adverse effects, analogs & derivatives, therapeutic use)
• Treatment Outcome