Older Adults With Myeloma: Second Primary Malignancy and Lenalidomide Therapy
Posted: Tuesday, September 29, 2020
In the Journal of Geriatric Oncology, Adam J. Olszewski, MD, of Alpert Medical School in Brown University, Providence, Rhode Island, and colleagues reported that first-line therapy with lenalidomide-based therapy does not appear to be linked to an increased risk of second primary malignancy in older adults with multiple myeloma. Their findings are based on data from more than 4,000 patients who received first-line lenalidomide in a population-based analysis.
“Our findings can be reassuring for patients and their oncologists concerned about such risk when choosing their first-line therapy for older adults with newly diagnosed myeloma,” commented the investigators.
Of more than 9,000 Medicare beneficiaries from the Surveillance, Epidemiology, and End Results (SEER)-Medicare database, Dr. Olszewski and colleagues identified adults at least 65 years of age with plasma cell myeloma diagnosed between 2007 and 2015 who had received at least one antimyeloma agent. Of these patients, 4,009 had been given lenalidomide in the first-line setting; this was defined as a therapy containing lenalidomide that was received within 90 days of diagnosis. A second primary malignancy was defined as a malignancy reported to a cancer registry more than 90 days after diagnosis.
Over a median follow-up of 5 years, 43% of patients (423) developed a second primary malignancy. Of these cancers, 85% (n = 361) were solid tumors, and 14% (n = 61) were hematologic malignancies. The rate of cumulative incidence of any second primary malignancy at 5 years was 5.3% in those who had received lenalidomide, which was similar to the rate in those who did not (4.4%; subhazard ratio = 1.06; P = .53). In addition, regarding the risk of solid tumors and hematologic malignancies, consistent results were reported (4.7% with lenalidomide versus 3.6% without it).
Disclosure: For full disclosures of the study authors, visit sciencedirect.com.
