Small Canadian lenalidomide trial on untreated CLL

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A small Canadian first-line lenalidomide trial has published in the Journal of

Clinical Oncology, Dec 28th, 2010

The first two patients experienced severe toxicities (fatal sepsis and tumour

lysis syndrome) on the initial dosage of 10 mg/d for 21 days of a 28-day cycle

and weekly 5-mg dose escalations to a target of 25 mg.

The study was halted and the dosages amended to 2.5 mg with monthly escalations

to a target dose of 10 mg, and extended tumor lysis prophylaxis and monitoring.

25 patients were enrolled on the amended protocol. No further tumour lysis

events were reported. Tumour flare was common (88%) but mild. Grade 3 to 4

neutropenia occurred in 72% of patients, with only five episodes of febrile

neutropenia. The overall response rate was 56% (no complete responses).

The study concludes: " 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. "

Abstract PMID: 21189385: http://www.ncbi.nlm.nih.gov/pubmed/21189385

~chris

CLL CANADA