Vorinostat in Combination With Lenalidomide and Dexamethasone in Lenalidomide-Refractory Multiple Myeloma

Clin Lymphoma Myeloma Leuk. 2016 Oct;16(10):558-562. doi: 10.1016/j.clml.2016.08.001. Epub 2016 Aug 10.

Abstract

Background: This is a retrospective chart review to evaluate the efficacy of the addition of vorinostat to lenalidomide and dexamethasone in patients with multiple myeloma relapsed/refractory to lenalidomide and dexamethasone.

Methods: Charts from 26 consecutive patients able to obtain commercial vorinostat were analyzed for response and safety data.

Results: The overall response rate was 31%, and the clinical beneficial rate was 50%. The median duration of response was 3 months, and the median overall survival was 28.5 months. The most common grade 3 and 4 toxicities were hematologic and metabolic, including neutropenia (44%), thrombocytopenia (53%), and transaminase elevations (aspartate aminotransferase 9% and alanine aminotransferase 6%). No thromboembolic events or febrile neutropenia were observed.

Conclusion: These observations demonstrate that the addition of vorinostat to patients with lenalidomide- and dexamethasone-refractory multiple myeloma was associated with moderate response and was well-tolerated, warranting further assessment in a larger prospective study.

Keywords: Histone deacetylase inhibitor; IMiD; Refractory relapse; Relapsed/refractory.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Dexamethasone / administration & dosage
  • Drug Resistance, Neoplasm
  • Humans
  • Hydroxamic Acids / administration & dosage
  • Lenalidomide
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / mortality
  • Multiple Myeloma / pathology
  • Neoplasm Staging
  • Recurrence
  • Retreatment
  • Survival Analysis
  • Thalidomide / administration & dosage
  • Thalidomide / analogs & derivatives
  • Treatment Outcome
  • Vorinostat

Substances

  • Hydroxamic Acids
  • Thalidomide
  • Vorinostat
  • Dexamethasone
  • Lenalidomide