Early treatment with lenalidomide significantly delays the progression of smouldering multiple myeloma to symptomatic disease, according to the results of a randomised trial.

Dr Sagar Lonial, of Emory University School of Medicine in Atlanta, and colleagues compared the efficacy of single-agent lenalidomide with observation only, the current standard of care for the precursor disease, in 182 patients with intermediate- or high-risk smouldering multiple myeloma.

The primary endpoint was progression-free survival based on disease progression to the development of end-organ damage attributable to multiple myeloma and biochemical progression.

The lenalidomide group received oral lenalidomide 25mg on days 1-21 of every 28-day cycle, with therapy (or observation) continued until disease progression, toxicity, or withdrawal for other reasons.