Do you recommend lenalidomide for high risk smoldering multiple myeloma?  

Given the PFS benefit seen in the most recent ECOG-ACRIN, and the prior study of Rd showing an OS benefit, is your practice to put any high-risk SMM patients on lenalidomide?

Would you add dexamethasone to the regimen, and if so in what circumstances?

Lonial et al. J Clin Oncol. 2019 Oct 25:JCO1901740. doi: 10.1200/JCO.19.01740.

Mateos et al. N Engl J Med 2013; 369:438-447. doi: 10.1056/NEJMoa1300439.

 



Answer from: Medical Oncologist at Academic Institution