{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T05:50:38Z","timestamp":1777009838588,"version":"3.51.4"},"reference-count":49,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T00:00:00Z","timestamp":1775088000000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Lenalidomide and low\u2010dose dexamethasone (Rd) is a standard regimen for transplant\u2010ineligible (TIE) patients with newly diagnosed multiple myeloma (NDMM), for whom a multi\u2010drug treatment regimen is not considered appropriate. While Rd has been intensively investigated in clinical trials, prospective real\u2010world data are still scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and Methods<\/jats:title>\n                    <jats:p>The prospective, multicenter, non\u2010interventional study FIRST\u2010NIS (NTC02537808) investigated the effectiveness, safety, and quality of life (QoL) of Rd in a German real\u2010world setting. G8\u2010Geriatric assessment was used to assess patients' impairment status. Patients were treated according to the physician's discretion. Data were analyzed descriptively; no formal hypothesis was tested.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2015 and 2018, 168 patients with TIE NDMM were included, median age was 77.7\u2009years. With a median follow\u2010up of 64.2\u2009months, median progression\u2010free survival (PFS) in the real\u2010world setting was 22.9\u2009months [95% CI 19.3, 28.1], median overall survival (OS) 58.1\u2009months [95% CI 45.7, 71.7]. Patients \u2264\u200975\u2009years and non\u2010impaired patients showed a more favorable PFS and OS, and Rd was a feasible treatment option in most patients with renal impairment. QoL was maintained during Rd treatment. No new safety signals emerged.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The results of the FIRST\u2010NIS support Rd as an effective and safe frontline treatment option for patients with TIE NDMM, irrespective of age, with similar clinical outcomes in the real world compared to the pivotal trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/clinicaltrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT02537808\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71758","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T03:04:18Z","timestamp":1775185458000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lenalidomide Plus Dexamethasone as FIRST\u2010Line Therapy in Transplant\u2010Ineligible Patients With Multiple Myeloma: Final Results of the Prospective, Non\u2010Interventional Study\n                    <scp>FIRST<\/scp>\n                    \u2010\n                    <scp>NIS<\/scp>\n                    and Comparison With the\n                    <scp>FIRST<\/scp>\n                    Pivotal Phase\n                    <scp>III<\/scp>\n                    Clinical Trial"],"prefix":"10.1002","volume":"15","author":[{"given":"H.","family":"N\u00fcckel","sequence":"first","affiliation":[{"name":"H\u00e4matologisch\/Onkologische Gemeinschaftspraxis Prof. Dr. N\u00fcckel\/Dr. Matschke  Bochum Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Behlendorf","sequence":"additional","affiliation":[{"name":"MVZ III Onkologie der Evidia MVZ Halle (Saale) GmbH  Halle (Saale) Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H.","family":"Schulz","sequence":"additional","affiliation":[{"name":"Praxis Internistischer Onkologie und H\u00e4matologie (PIOH)  Frechen Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Schulze","sequence":"additional","affiliation":[{"name":"Praxis und Tagesklinik f\u00fcr H\u00e4matologie\/Onkologie  Zittau Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Schardt","sequence":"additional","affiliation":[{"name":"Gemeinschaftspraxis Dres. 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