Drug appears safe as first-line single-agent treatment for chronic lymphocytic leukemia

Thursday, December 30, 2010 (Last Updated: 01/03/2011)

THURSDAY, Dec. 30 (HealthDay News) -- The oral immunomodulatory drug lenalidomide appears to be clinically active and well tolerated as a first-line, single-agent treatment for chronic lymphocytic leukemia (CLL) if given conservatively, according to research published online Dec. 28 in the Journal of Clinical Oncology.

Christine I. Chen, M.D., of the Princess Margaret Hospital/Ontario Cancer Institute in Toronto, and colleagues treated 25 CLL patients with lenalidomide starting at 2.5 mg and escalating monthly to 10 mg (after discontinuing an earlier protocol that started at 10 mg and had more rapid escalations, which resulted in severe toxicities) to investigate the potential of single-agent lenalidomide as a first-line treatment for this patient population.

The researchers observed an overall response rate of 56 percent, though with no complete responses. Rebound lymphocytoses were common during therapy off-weeks, but the researchers observed rapid peripheral lymphocyte reductions. Mild tumor flare occurred in 88 percent, and grade 3 to 4 neutropenia in 72 percent, but there were only five episodes of febrile neutropenia. The researchers identified cytoskeletal and immune-related genes induced by lenalidomide.

"Lenalidomide is clinically active as first-line CLL therapy and is well tolerated if a conservative approach with slow dose escalation is used. A lenalidomide-induced molecular signature provides insights into its immunomodulatory mechanisms of action in CLL," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies.

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Specialties Hematology & Oncology

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