Efficacy and safety of lenalidomide for the treatment of acute myeloid leukemia: a systematic review and meta-analysis

• Published in: Cancer management and research Vol. 10; pp. 3637 - 3648
• Main Authors: Xie, Chun-Hong, Wei, Min, Yang, Fei-Yan, Wu, Fu-Zhen, Chen, Lei, Wang, Jian-Kun, Liu, Qin, Huang, Jin-Xiong
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Acute myelocytic leukemia; adverse events; Age; Analysis; Anemia; Angiogenesis inhibitors; azacitidine; Bias; Cancer treatment; complete remission; Dosage and administration; Drug therapy; Epidemiology; Hematology; Immunotherapy; Lenalidomide; Leukemia; Medical prognosis; Medical research; Meta-analysis; MicroRNAs; Myelodysplastic syndromes; Myeloid leukemia; Neutropenia; Operating systems (Software); Original Research; overall response rate; Patient outcomes; Safety and security measures; Statistical analysis; Studies; Systematic review; Targeted cancer therapy; Thrombocytopenia; United States > US; cytarabine; cytogenetic risk; immunomodulatory agent; azacitidine
• ISSN: 1179-1322; 1179-1322
• DOI: 10.2147/CMAR.S168610

Lenalidomide is effective for the treatment of low-risk myelodysplastic syndromes with deletion 5q abnormalities. However, whether lenalidomide leads to a significant improvement in treatment response and overall survival (OS) in cases of acute myeloid leukemia (AML) remains controversial. A systematic review and a meta-analysis were performed to evaluate the efficacy and safety of lenalidomide in the treatment of AML. Clinical studies were identified from the Cochrane Central Register of Controlled Trials, PubMed, Embase, and ClinicalTrials.gov. Efficacy outcomes included overall response rate (ORR), complete remission (CR), and OS. Safety was evaluated based on the incidence of grade 3 and 4 treatment-related adverse events (AEs). Eleven studies were included in our meta-analysis; collectively these studies featured 407 AML patients. Pooled estimates for overall ORR and CR were 31% (95% CI: 26%-36%) and 21% (95% CI: 16%-27%), respectively. Thrombocytopenia, anemia, neutropenia, and infection were the most common grade 3 and 4 AEs. Lenalidomide may have some clinical activity in AML, but the population that would benefit from lenalidomide and incorporating lenalidomide into combination drug strategies need to be better defined.