Efficacy of lenalidomide in relapsed/refractory chronic lymphocytic leukemia patient: a systematic review and meta-analysis

[AussieNeil]

Given the interest in my recent response to Broadbent about whether our immune system will get better after treatment: healthunlocked.com/cllsuppo... , I coincidentally came across this recent paper on Lenalidomide/Revlimid, where unusually for CLL treatment (along with Ibrutinib), immunoglobulin levels increased after treatment : link.springer.com/article/1...

In a recent article published in the Annals of Hematology, researchers from China reported the results of a literature review and meta-analysis that evaluated the response to lenalidomide in 559 patients with relapsed or refractory CLL.

* Lenalidomide administered alone showed only a modest response in patients, with an overall response rate (ORR) of 24.4% and a complete response (CR) of only 3%

* A significantly higher response was noted in patients who received lenalidomide plus an anti-CD20 monoclonal antibody, with an ORR of 60% and a CR of 13%

Some historical background from the CLL Updates 2011: updates.clltopics.org/3728-...

Now for some very encouraging news: as most of you know, CLL patients are prone to low immunoglobulin levels and these levels drop as the disease progresses. Low immunoglobulin levels are one reason why our guys are more prone to infections. Lenalidomide therapy seems to be unique in reversing this trend in immunoglobulin levels. In patients who finished at least 15 cycles of therapy, immunoglobulin levels increased across all Ig classes (IgG, IgA and IgM).

Subsequently 'The U.S. Food and Drug Administration (FDA) halted a clinical trial of the anti-cancer drug Revlimid (lenalidomide) because of significant safety concerns. The ORIGIN trial (NCT00910910), which was evaluating Revlimid treatment for a new use as an initial therapy for chronic lymphocytic leukemia (CLL) in patients 65 years and older, showed higher rates of death in patients treated with Revlimid compared to those treated with chlorambucil.' : fda.gov/Drugs/DrugSafety/uc...

So the search for a treatment that controls or eliminates CLL and restores our immune system continues...

Neil

[cllady01 Former Volunteer]

Neil, is immunoglobulin tested in CBC/FBC? Does a neutrophil count show that?

[Cllcanada Top Poster CURE Hero in reply to cllady01]

Its a special panel of tests, not usually performed every CBC, unless they are being tracked... they test for immunoglobulins A,M and G

Has nothing to do with neutrophils...

[cllady01 Former Volunteer in reply to Cllcanada]

Thank you, but it is done as a blood test, I surmise from your answer.

[Cllcanada Top Poster CURE Hero in reply to cllady01]

Yes... it can be added to the regular CBC/FBC... I get one occasionally, they don't see a need to run it every time, but then I get a lot of blood work done... 💉💉💉 🤤

[cllady01 Former Volunteer]

When Revlimid was being tested in trials, my first hemo/onco was excited about its possibilities and mentioned it might be something for me at some point. That was quite a let-down for both of us when the results were seen.

[Cllcanada Top Poster CURE Hero]

Lenalidomide is a thalidomide tweak.. an old post war German drug from the late '40s, that caused horrendous birth defects... when used to treat morning sickness... back in the 1950, and it is a lesson in greed ...

It has always fascinated researchers as an immunomodulator, and I know a few CLL patients treated on it 10 years ago who are doing well...

It has never had enough efficacy in CLL to get to the FDA process, but still holds some promise... Celgene has a newer tweak CC-122 and it is entering early trials...

Stay tuned...

~chris