ESMO 2018: Strategy for Offsetting Lenalidomide-Induced Rash in Multiple Myeloma
Posted: Wednesday, October 24, 2018
Bortezomib treatment prior to lenalidomide therapy may lower the incidence of rash in patients with multiple myeloma. The two drugs seem to have opposing effects on the immune system, reported Tomohiro Terada, PhD, of the Shiga University of Medical Science Hospital, and colleagues. Their findings were presented at the 2018 European Society for Medical Oncology (ESMO) Congress in Munich (Abstract 1026P).
“[Lenalidomide] has immunomodulatory effects activating the function of effector immune cells such as T cells, which may result in rash onset. Conversely, bortezomib, another key drug of [multiple myeloma] therapy, has strong immunosuppressive effects,” the authors reasoned.
In this multicenter cohort study, patients with multiple myeloma receiving lenalidomide therapy were divided into those who had prior bortezomib therapy and those who did not. Of the 144 patients followed, 50 patients (35%) developed rash, and lenalidomide therapy was discontinued for 17 (34%). The median time to the onset of rash was 8.5 days after lenalidomide exposure. The incidence of rash was significantly lower in patients who had prior bortezomib therapy compared with those who did not (30% vs. 53%, P = .04). Moreover, in patients who developed rash, the median duration of prior bortezomib therapy was shorter (109 days) than in those who did not develop rash (164 days). Finally, patients who developed rash exhibited a higher incidence of eosinophilia than did patients who had no rash (26% vs. 8%, P < .01).
