Stewart et al., 2015 1818 Stewart AK, Jacobus S, Fonseca R, Weiss M, Callander NS, Chanan-Khan AA, Rajkumar SV. Melphalan, prednisone, and thalidomide vs melphalan, prednisone, and lenalidomide (ECOG E1A06) in untreated multiple myeloma. Blood 2015; 126(11):1294-1301.
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Phase III Randomized Controlled Trial (non-inferiority design) |
Elderly patients with untreated MM |
MPT-T versus MPR-R |
No difference in RR, PFS, and OS |
MPR-R: lower incidence of peripheral neuropathy. |
Zweegman et al., 2016 1919 Zweegman S, van der Holt B, Mellqvist UH, Salomo M, Bos GM, Levin MD, Visser-Wisselaar H, Hansson M, van der Velden AW, Deenik W, Gruber A, Coenen JL, Plesner T, Klein SK, Tanis BC, Szatkowski DL, Brouwer RE, Westerman M, Leys MR, Sinnige HA, Haukås E, van der Hem KG, Durian MF, Mattijssen EV, van de Donk NW, Stevens-Kroef MJ, Sonneveld P, Waage A. Melphalan, prednisone, and lenalidomide versus melphalan, prednisone, and thalidomide in untreated multiple myeloma. Blood 2016; 127(9):1109-1116.
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Phase III Multicenter open-label RCT (study design similar to that of Stewart et al.'s trial) |
Newly-diagnosed MM who were ineligible to stem cell transplant |
MPT-T versus MPR-R |
No difference in PFS (primary efficacy endpoint) |
MPT-T: increased incidence of peripheral neuropathy MPR-R: increased incidence of hematologic toxicity requiring growth factor support. |
Gay et al., 2010 2020 Gay F, Hayman SR, Lacy MQ, Buadi F, Gertz MA, Kumar S, Dispenzieri A, Mikhael JR, Bergsagel PL, Dingli D, Reeder CB, Lust JA, Russell SJ, Roy V, Zeldenrust SR, Witzig TE, Fonseca R, Kyle RA, Greipp PR, Stewart AK, Rajkumar SV. Lenalidomide plus dexamethasone versus thalidomide plus dexamethasone in newly diagnosed multiple myeloma: a comparative analysis of 411 patients. Blood 2010; 115(7):1343-1350.
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Observational (case-control designed) retrospective study. Matched-pair analysis adjusted for age, sex, transplantation, DXM dose. |
Newly diagnosed MM patients (initial therapy) |
Lenalidomide + DXM versus Thalidomide + DXM. |
Lenalidomide + DMX: longer TTP (median 27.4 versus 17.2 mo), PFS (26.7 versus 17.1 mo); OS (not reached versus 57.2 mo). |
Similar proportion of patients in the 2 groups experienced at least one grade 3 or 4 adverse event (thalidomide versus lenalidomide: 54.6% versus 57.5%)#
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Sashidharan et al. 2015 2121 Sashidharan N, Shenoy S, Kishore MK, Thanusubramanian H. Comparison of Two Therapeutic Regimes, Lenalidomide with Dexamethasone and Thalidomide with Dexamethasone, in the Treatment of Multiple Myeloma at a Tertiary Care Hospital in India. J Clin Diagn Res 2015; 9(5):XC01-XC04.
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Observational (analysis of medical record files) retrospective study. |
Newly diagnosed MM patients who attended medical care in tertiary hospitals in India. |
Thalidomide + DXM (n=17) versus lenalidomide+DXM (n=19) |
Proportion of patients showing minimal and partial clinical response to treatment (serum immunoglobulin levels, bone marrow biopsy) |
Proportion of adverse events did not differ. Yet not differing statistically, 04 (23.5%) patients treated with thalidomide presented neuropathy against 01 (5.3%) that received lenalidomide. |
Luo et al., 2017 2222 Luo J, Gagne JJ, Landon J, Avorn J, Kesselheim AS. Comparative effectiveness and safety of thalidomide and lenalidomide in patients with multiple myeloma in the United States of America: A population-based cohort study. Eur J Cancer 2017; 70:22-33.
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Observational (population-based cohort). |
Patients with MM receiving thalidomide or lenalidomide in routine care in the US. (N= 1264) |
Thalidomide-based versus lenalidomide-based therapies |
No difference in rates of death (HR: 95% CI, 1.00: 0.71-1.41) |
Lenalidomide-based therapies: lower risk of peripheral neuropathy (HR: 95%CI, 0.71: 0.56-0.92). |