Treatment with lenalidomide (Revlimid®), cyclophosphamide (Endoxan®) and prednisone (REP) in relapsed/refractory multiple myeloma patients: results of a single centre retrospective study

• Published in: Acta clinica belgica (English ed. Online) Vol. 69; no. 2; pp. 98 - 103
• Main Authors: Zelis, N., Devos, T., Dierickx, D., Janssens, A., Raddoux, J., Verhoef, G., Delforge, M.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis 01.04.2014; Taylor & Francis Ltd
• Subjects: Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Clinical trials; Cyclophosphamide - administration & dosage; Cyclophosphamide - adverse effects; Drug therapy; Embolisms; Female; Hematology; Humans; Male; Middle Aged; Multiple myeloma; Multiple Myeloma - drug therapy; Prednisone - administration & dosage; Prednisone - adverse effects; REP; Response rates; Retrospective Studies; Studies; Thalidomide - administration & dosage; Thalidomide - adverse effects; Thalidomide - analogs & derivatives; Treatment; REP; Treatment; Multiple myeloma
• ISSN: 1784-3286; 2295-3337
• DOI: 10.1179/0001551214Z.00000000030

Lenalidomide (Revlimid®) combined with intermittent dexamethasone (the RD regimen) is one of the current standards for treatment of patients with relapsed/refractory multiple myeloma (MM). However, since the disease in the majority of patients will become resistant to RD, or treatment with RD needs to be discontinued due to side effects, we evaluated the combination lenalidomide, low-dose oral cyclophosphamide, with prednisone (REP) in patients with relapsed/refractory MM previously exposed to RD. For this purpose, we performed a single centre retrospective study of the efficacy of REP in 19 patients with relapsed/refractory MM. Overall response rate (partial response or better) with REP was 68% compared with 83% with RD, but with a shorter time to response with the triplet REP. Time to progression after REP was 6 months. Overall the REP regimen was better tolerated compared to RD. We conclude that the REP regimen is an effective treatment regimen for patients with relapsed/refractory MM with good tolerance, warranting further exploration in prospective randomized trials.