{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:22:13Z","timestamp":1785406933429,"version":"3.56.0"},"reference-count":22,"publisher":"SAABRON PRESS","issue":"4","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>The use of proteasome inhibitors (PI) and immunomodulatory drugs (IMiD) such as lenalidomide (Len) in early lines of therapy in multiple myeloma (MM) has resulted in a high proportion of patients with relapsed or refractory multiple myeloma (RRMM) being Len-refractory. Len refractoriness is associated with inferior outcomes, constituting an unmet need in clinical practice. This retrospective single-center study aimed to provide real-world characteristics and outcomes in RRMM previously exposed to PI and Len during 1-3 prior lines of therapy (LOT), stratified by Len refractoriness. RRMM patients between Jan 2017 and May 2023 were included. We studied clinical characteristics, treatments and survival outcomes. A total of 218 patients were included (n=85 Len refractory). The median progression-free survival was 13.6 months in Len-refractory versus 14.9 months in Len non-refractory patients. The median overall survival was 20.3 months in Len refractory, and not reached in Len non-refractory patients. The overall response rates to the subsequent LOT were 58.8% and 61.7% in Len refractory and non-refractory cohorts, respectively. IMiD-based and anti-CD38 monoclonal antibody-containing regimens were the most frequent subsequent LOT, 44% and 41%, respectively. This study shows suboptimal outcomes in Len refractory RRMM patients, highlighting the need to develop effective treatment options.<\/jats:p>","DOI":"10.46989\/001c.146250","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:36:51Z","timestamp":1766500611000},"source":"Crossref","is-referenced-by-count":0,"title":["Real-world outcomes in patients with relapsed and refractory multiple myeloma with prior proteasome inhibitor and lenalidomide exposure: A single-center study in Sweden"],"prefix":"10.46989","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9825-6706","authenticated-orcid":true,"given":"Vincent","family":"Luong","sequence":"first","affiliation":[{"name":"Department of Medicine, Center for Hematology and Regenerative Medicine, Karolinska Institutet, Stockholm, Sweden"},{"id":[{"id":"https:\/\/ror.org\/00m8d6786","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Hematology, Karolinska University Hospital, 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