{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T01:59:05Z","timestamp":1755223145966,"version":"3.43.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T00:00:00Z","timestamp":1524096000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lenalidomide (Len) plus dexamethasone (Dex) is approved for the treatment of relapsed or refractory multiple myeloma (RRMM). It is possible that single\u2010agent Len may be effective as prolonged treatment regimen in RRMM once patients demonstrate an initial response to Len+Dex induction. Patients with RRMM who responded to first\u2010line Len+Dex in an observational study (NCT01430546) received up to 24 cycles of either Len (25\u00a0mg\/day) or Len+Dex (25\u00a0mg\/day and 40\u00a0mg\/week) as prolonged treatment in a subsequent phase 2 clinical trial (NCT01450215). In the observational study (<jats:italic>N<\/jats:italic>\u00a0=\u00a0133), median time to response was 1.7 (range 0.6\u20139.6) months. A complete response to all treatments received in both studies was observed in 11% of patients; very good partial response and partial response rates were 31% and 38%, respectively. Corresponding response rates in the subgroup of patients who did not enter the phase 2 trial (<jats:italic>n<\/jats:italic>\u00a0=\u00a071) were 3%, 18%, and 39%, respectively. Rates of disease progression at 2\u00a0years in the phase 2 trial were 47% versus 31% for Len versus Len+Dex (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.14). After 36\u00a0months median follow\u2010up in surviving patients, median time to progression was not reached with Len+Dex and was 24.9\u00a0months (95% confidence interval 12.5\u2013not calculable, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) with Len. Three\u2010year OS among the total observational study population was 61% (95% CI, 52\u201369%). The corresponding rate among patients who entered the phase 2 clinical trial was 73% (95% CI, 60\u201383%) and was significantly lower among those patients who achieved \u2265PR but did not proceed into the phase 2 trial (55%; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). In the phase 2 trial, OS was 73% in both treatment arms (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.70). Neutropenia and thrombocytopenia were more common with prolonged (phase 2 trial) versus short\u2010term (observational study) Len administration but remained manageable. Prolonged treatment with Len with or without Dex provides sustained, clinically relevant responses and demonstrates an acceptable safety profile.<\/jats:p>","DOI":"10.1002\/cam4.1422","type":"journal-article","created":{"date-parts":[[2018,4,19]],"date-time":"2018-04-19T13:45:34Z","timestamp":1524145534000},"page":"2256-2268","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Lenalidomide versus lenalidomide\u00a0+\u00a0dexamethasone prolonged treatment after second\u2010line lenalidomide\u00a0+\u00a0dexamethasone induction in multiple myeloma"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5753-8168","authenticated-orcid":false,"given":"Johan","family":"Lund","sequence":"first","affiliation":[{"name":"Department of Hematology Karolinska University Hospital  Stockholm 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Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Agneta","family":"Swedin","sequence":"additional","affiliation":[{"name":"Department of Hematology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Hematology Sk\u00e5ne University Hospital  Lund Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Forsberg","sequence":"additional","affiliation":[{"name":"Department of Hematology Norrland University Hospital  Ume\u00e5 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia","family":"Ahlberg","sequence":"additional","affiliation":[{"name":"Department of Hematology University Hospital of Link\u00f6ping  Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Conny","family":"Carlsson","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Hallands Hospital  Halmstad Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anders","family":"Waage","sequence":"additional","affiliation":[{"name":"Department of Cancer Research and Molecular Medicine Norwegian University of Science and Technology  Trondheim Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Gimsing","sequence":"additional","affiliation":[{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annette Juul","family":"Vangsted","sequence":"additional","affiliation":[{"name":"Department of Hematology Rigshospitalet  Copenhagen Denmark"},{"name":"Department of Hematology Zealand University  Roskilde Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ulf","family":"Fr\u00f8lund","sequence":"additional","affiliation":[{"name":"Department of Hematology Zealand University  Roskilde Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Holmberg","sequence":"additional","affiliation":[{"name":"Department of Oncology Institute of Clinical Sciences  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00f6sta","family":"Gahrton","sequence":"additional","affiliation":[{"name":"Department of Hematology Karolinska University Hospital  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evren","family":"Alici","sequence":"additional","affiliation":[{"name":"Department of Hematology Karolinska University Hospital  Stockholm 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