FACULTY COMMENTS
DR ORLOWSKI: This paper reports on one of the two studies
that led to the combination of lenalidomide and dexamethasone
becoming a standard approach for relapsed or refractory multiple
myeloma. Comparing the combination to dexamethasone alone,
the median time to progression was approximately 11 months as
opposed to less than five months, respectively, and the median
overall survival had not yet been reached for the combination but
was approximately 20.6 months for dexamethasone alone.
Thromboembolic events were more common with the combination, and I believe most people in the field would recommend prophylactic anticoagulants, although debate with regard to the specific strategy continues. The International Myeloma Working Group published a consensus paper in Leukemia, with Antonio Palumbo as the lead author, which says every patient who receives lenalidomide and low-dose dexamethasone should take a baby aspirin daily, at the minimum.
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