Difference between revisions of "Smoldering multiple myeloma"

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!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
!style="width: 25%"|[[Levels_of_Evidence#Comparative_efficacy|Comparative Efficacy]]
 
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|-
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|[https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 Mateos et al. 2013]
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|[https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 Mateos et al. 2013 (QUIREDEX)]
 
| style="background-color:#1a9851" |Phase III (E)
 
| style="background-color:#1a9851" |Phase III (E)
 
|[[#Observation|Observation]]
 
|[[#Observation|Observation]]
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|}
 
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''Note: this trial did not require modern imaging modalities to rule out active myeloma, and therefore it is probable that many patients on this study had active as opposed to smoldering multiple myeloma.''
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''Note: QUIREDEX did not require modern imaging modalities (such as MRI) to rule out active myeloma, and therefore it is probable that many patients on this study had active as opposed to smoldering multiple myeloma.''
 
====Chemotherapy====
 
====Chemotherapy====
 
*[[Lenalidomide (Revlimid)]] 25 mg PO once per day on days 1 to 21
 
*[[Lenalidomide (Revlimid)]] 25 mg PO once per day on days 1 to 21
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===References===
 
===References===
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# Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. doi: 10.1056/NEJMoa1300439. PubMed PMID: 23902483. [https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23902483 PubMed]
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# '''QUIREDEX:''' Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. [https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23902483 PubMed]
  
 
==Observation==
 
==Observation==
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| style="background-color:#d73027" |Inferior PFS
 
| style="background-color:#d73027" |Inferior PFS
 
|-
 
|-
−
|[https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 Mateos et al. 2013]
+
|[https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 Mateos et al. 2013 (QUIREDEX)]
 
| style="background-color:#1a9851" |Phase III (C)
 
| style="background-color:#1a9851" |Phase III (C)
 
|[[#Rd|Rd]]
 
|[[#Rd|Rd]]
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===References===
 
===References===
 
# '''ECOG E3A06:''' Lonial S, Jacobus S, Fonseca R, Weiss M, Kumar S, Orlowski RZ, Kaufman JL, Yacoub AM, Buadi FK, O'Brien T, Matous JV, Anderson DM, Emmons RV, Mahindra A, Wagner LI, Dhodapkar MV, Rajkumar SV. Randomized trial of lenalidomide versus observation in smoldering multiple myeloma. J Clin Oncol. 2019 Oct 25:JCO1901740. [Epub ahead of print] [https://ascopubs.org/doi/full/10.1200/JCO.19.01740 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/23958922 PubMed]
 
# '''ECOG E3A06:''' Lonial S, Jacobus S, Fonseca R, Weiss M, Kumar S, Orlowski RZ, Kaufman JL, Yacoub AM, Buadi FK, O'Brien T, Matous JV, Anderson DM, Emmons RV, Mahindra A, Wagner LI, Dhodapkar MV, Rajkumar SV. Randomized trial of lenalidomide versus observation in smoldering multiple myeloma. J Clin Oncol. 2019 Oct 25:JCO1901740. [Epub ahead of print] [https://ascopubs.org/doi/full/10.1200/JCO.19.01740 link to original article] [https://www.ncbi.nlm.nih.gov/pubmed/23958922 PubMed]
−
# Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. doi: 10.1056/NEJMoa1300439. PubMed PMID: 23902483. [https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23902483 PubMed]
+
# '''QUIREDEX:''' Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. [https://www.nejm.org/doi/full/10.1056/NEJMoa1300439 link to original article] '''contains verified protocol''' [https://www.ncbi.nlm.nih.gov/pubmed/23902483 PubMed]
  
 
[[Category:Smoldering multiple myeloma regimens]]
 
[[Category:Smoldering multiple myeloma regimens]]
 
[[Category:Disease-specific pages]]
 
[[Category:Disease-specific pages]]
 
[[Category:Plasma cell dyscrasias]]
 
[[Category:Plasma cell dyscrasias]]

Revision as of 15:54, 3 November 2019

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 Samuel M. Rubinstein, MD
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 Andrew J. Cowan, MD
University of Washington
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4 regimens on this page
7 variants on this page


All lines of therapy

Lenalidomide monotherapy

back to top

Regimen

Study Evidence Comparator Comparative Efficacy
Lonial et al. 2019 (ECOG E3A06) Phase III (E) Observation Superior PFS

Chemotherapy

Supportive medications

28-day cycles

References

  1. ECOG E3A06: Lonial S, Jacobus S, Fonseca R, Weiss M, Kumar S, Orlowski RZ, Kaufman JL, Yacoub AM, Buadi FK, O'Brien T, Matous JV, Anderson DM, Emmons RV, Mahindra A, Wagner LI, Dhodapkar MV, Rajkumar SV. Randomized trial of lenalidomide versus observation in smoldering multiple myeloma. J Clin Oncol. 2019 Oct 25:JCO1901740. [Epub ahead of print] link to original article contains verified protocol PubMed


Rd

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Regimen

Study Evidence Comparator Comparative Efficacy
Mateos et al. 2013 (QUIREDEX) Phase III (E) Observation Seems to have superior OS

Note: QUIREDEX did not require modern imaging modalities (such as MRI) to rule out active myeloma, and therefore it is probable that many patients on this study had active as opposed to smoldering multiple myeloma.

Chemotherapy

Supportive medications

28-day cycle for 9 cycles

Subsequent treatment

References

  1. QUIREDEX: Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. link to original article contains verified protocol PubMed

Observation

back to top

Regimen

Study Evidence Comparator Comparative Efficacy
Lonial et al. 2019 (ECOG E3A06) Phase III (C) Lenalidomide Inferior PFS
Mateos et al. 2013 (QUIREDEX) Phase III (C) Rd Seems to have inferior OS

No treatment.

References

  1. ECOG E3A06: Lonial S, Jacobus S, Fonseca R, Weiss M, Kumar S, Orlowski RZ, Kaufman JL, Yacoub AM, Buadi FK, O'Brien T, Matous JV, Anderson DM, Emmons RV, Mahindra A, Wagner LI, Dhodapkar MV, Rajkumar SV. Randomized trial of lenalidomide versus observation in smoldering multiple myeloma. J Clin Oncol. 2019 Oct 25:JCO1901740. [Epub ahead of print] link to original article PubMed
  2. QUIREDEX: Mateos MV, Hernández MT, Giraldo P, de la Rubia J, de Arriba F, López Corral L, Rosiñol L, Paiva B, Palomera L, Bargay J, Oriol A, Prosper F, López J, Olavarría E, Quintana N, García JL, Bladé J, Lahuerta JJ, San Miguel JF. Lenalidomide plus dexamethasone for high-risk smoldering multiple myeloma. N Engl J Med. 2013 Aug 1;369(5):438-47. link to original article contains verified protocol PubMed
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