Treatment of smoldering myeloma delays progression, study finds

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Use of the drug lenalidomide instead of observation can delay symptom progression and organ damage.

Results of a study on smoldering multiple myeloma presented at the 2019 American Society of Clinical Oncology Annual Meeting suggest that the cancer drug lenalidomide may delay the onset of myeloma symptoms.

Photo of S. Vincent Rajkumar, M.D.
S. Vincent Rajkumar, M.D.

"At present, the standard of care for smoldering multiple myeloma is observation without therapy," said lead study author S. Vincent Rajkumar, M.D., a hematologist at Mayo Clinic in Rochester, Minnesota, and the Edward W. and Betty Knight Scripps Professor of Medicine in Honor of Dr. Edward C. Rosenow, III. "We found that treatment of smoldering myeloma delays progression to symptomatic myeloma and can prevent damage to organs that occurs in multiple myeloma."

The findings are consistent with the findings of a recent Spanish study, and together they may support a change in clinical practice, Dr. Rajkumar said.

The Mayo Clinic study followed 182 patients, 92 of whom received the drug lenalidomide (Revlimid). The other 90 patients didn't receive the drug but were observed. Almost half of the patients who received the drug responded to therapy, while no change was reported among observation patients. Serious adverse events occurred in 28% of patients taking lenalidomide, but Dr. Rajkumar says those events were considered manageable.

"Our results show that it is possible to delay progression to multiple myeloma, a serious cancer with significant morbidity, by early therapy administered when the disease is still asymptomatic," he said.


This article was originally published in Forefront, Mayo Clinic Cancer Center's online magazine, which ceased publication in December 2020.