{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,10]],"date-time":"2026-05-10T07:05:50Z","timestamp":1778396750352,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,6,27]],"date-time":"2021-06-27T00:00:00Z","timestamp":1624752000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006436","name":"Celgene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006436","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lenalidomide is an important component of initial therapy in newly diagnosed multiple myeloma, either as maintenance therapy post\u2010autologous stem cell transplantation (ASCT) or as first\u2010line therapy with dexamethasone for patients\u2019 ineligible for ASCT (non\u2010ASCT). This retrospective study investigated treatment patterns and outcomes for ASCT\u2010eligible and \u2010ineligible patients who relapsed after lenalidomide as part of first\u2010line therapy, based on data from the Canadian Myeloma Research Group Database for patients treated between January 2007 and April 2019. Among 256 patients who progressed on lenalidomide maintenance therapy, 28.5% received further immunomodulatory derivative\u2010based (IMiD\u2010based) therapy (lenalidomide\/pomalidomide) without a proteasome inhibitor (PI) (bortezomib\/carfilzomib\/ixazomib), 26.2% received PI\u2010based therapy without an IMiD, 19.5% received both an IMiD plus PI, 13.5% received daratumumab\u2010based regimens, and 12.1% underwent salvage ASCT. Median progression\u2010free survival (PFS) was longest for daratumumab\u2010based therapy (22.7\u00a0months) and salvage ASCT (23.4\u00a0months) and ranged from 6.6 to 7.3\u00a0months for the other treatments (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.0001). Median overall survival (OS) was also longest for daratumumab and salvage ASCT. A total of 87 non\u2010ASCT patients received subsequent therapy, with 66.7% receiving bortezomib\u2010based therapy and 13.8% receiving other PI\u2010based therapy. Median PFS was 15.4 and 24.8\u00a0months for bortezomib\u2010based and other PI\u2010based therapy, respectively (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.404). During most of the study period, daratumumab was not funded; in this setting, switching to a different therapeutic class following relapse on lenalidomide produced the longest remissions for non\u2010ASCT patients. Further prospective studies are warranted to determine optimum treatment following relapse on lenalidomide, especially in the light of increased access to daratumumab.<\/jats:p>","DOI":"10.1111\/ejh.13678","type":"journal-article","created":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T19:20:03Z","timestamp":1623784803000},"page":"416-427","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Retrospective study of treatment patterns and outcomes post\u2010lenalidomide for multiple myeloma in Canada"],"prefix":"10.1111","volume":"107","author":[{"given":"Donna E.","family":"Reece","sequence":"first","affiliation":[{"name":"Department of Medical Oncology and Hematology Princess Margaret Cancer Centre  Toronto ON Canada"},{"name":"Canadian Myeloma Research Group  Toronto ON 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