A major phase 3 trial has found that patients with multiple myeloma who took lenalidomide for two years lived just as long at seven years as those who stayed on the drug indefinitely — and faced fewer serious side effects.
The findings come from the ENDURANCE trial, published in the New England Journal of Medicine, and could change how doctors approach long-term treatment for multiple myeloma (a cancer of plasma cells in the bone marrow). The trial tracked patients over seven years, comparing two distinct approaches: a fixed two-year course of lenalidomide against open-ended, indefinite use of the same drug.
Overall survival rates at seven years were similar between the two groups. That’s a meaningful result — it suggests patients don’t need to stay on the drug for life to get the same survival benefit.
But the differences in harm were stark. According to the trial results, adverse events and second cancers were more common among patients who continued lenalidomide indefinitely. Lenalidomide is an immunomodulatory drug — it works by altering the immune system’s response to cancer cells — and prolonged exposure appears to carry real risks.
The ENDURANCE trial is a phase 3 study, meaning it tested the treatment in a large group of patients under controlled conditions — the standard required before findings can influence clinical guidelines. The New England Journal of Medicine is one of the most widely read peer-reviewed medical journals in the world.
For patients in Kent currently receiving lenalidomide as maintenance therapy, or those about to begin it, the research does not mean treatment should change without medical advice. Any questions about duration of treatment should be raised with a haematologist or specialist nurse.
NHS 111 can advise on accessing specialist services. Patients with cancer-related concerns can also contact their GP or the clinical team managing their care directly.
Source: @NEJM
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