A phase 2 study of lenalidomide monotherapy in patients with deletion 5q acute myeloid leukemia: Southwest Oncology Group Study S0605
Open accessAbstract
Older acute myeloid leukemia (AML) patients with a chromosome 5q deletion have poor outcomes with conventional chemotherapy. This phase 2 study explored the safety and efficacy of single-agent lenalidomide in previously untreated older AML patients with del(5q) who declined standard chemotherapy. Patients were treated with lenalidomide 50 mg daily for 28 days as induction therapy and 10 mg daily for 21 days of a 28-day cycle as maintenance until disease progression or unacceptable toxicity. Among 37 evaluable patients, the median age was 74 years (range, 60-94), 21 (57%) were female, 19 (51%) had prior myelodysplastic syndrome, and 30 (81%) had pretreatment cytogenetic studies evaluated centrally. Six had isolated del(5q), 1 had del(5q) and +8, 23 had complex cytogenetics, and 7 others had del(5q) identified locally. Fourteen patients (38%) completed induction therapy: 7 patients died during induction therapy, 8 had disease progression, 7 had nonfatal adverse events, and 1 entered hospice. Eight patients started maintenance therapy. Five patients (14%) achieved a partial or complete response, 2 with isolated del(5q) and 3 with complex cytogenetics. Relapse-free survival was 5 months (range, 0-19). Median overall survival was 2 months for the entire population. In conclusion, lenalidomide as a single agent has modest activity in older del(5q) AML patients. Southwest Oncology Group Study S0605 is registered at www.clinicaltrials.gov as NCT00352365.
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Despite 5q-MDS often progressing into AML and many AML patients harboring 5q abnormalities, targeting CK1α with lenalidomide showed only a modest therapeutic effect.
“Surprisingly, despite 5q-MDS often progressing into AMl and many AMl patients harboring 5q abnormalities, targeting cK1α with lenalidomide showed only a modest therapeutic effect (Sekeres et al. 2011).”
From From serendipity to strategy: molecular glue degraders in cancer therapeutics (2025) · cites this paper as Sekeres et al. 2011
Altered regulation of gene expression as a result of IKZF1 degradation might also contribute to responsiveness of myeloid malignancies to lenalidomide.
“Thus, altered regulation of gene expression as a result of IKZF1 degradation might also contribute to responsiveness of myeloid malignancies to lenalidomide97,101.”
From Cancer therapies based on targeted protein degradation — lessons learned with lenalidomide (2021) · cites this paper as [101]
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- Authors
- Sekeres, M. A., Gundacker, H., Lancet, J., Advani, A., Petersdorf, S., Liesveld, J., Mulford, D., Norwood, T., Willman, C. L., Appelbaum, F. R., & List, A. F.
- Affiliations
- Cleveland Clinic (US)
- SWOG Cancer Research Network (US)
- Moffitt Cancer Center (US)
- Seattle Cancer Care Alliance (US)
- University of Rochester (US)
- University of Washington (US)
- UNM Comprehensive Cancer Center (US)
- Fred Hutch Cancer Center (US)
- ORCID
- Venue
- Blood
- Publisher
- American Society of Hematology
- Published
- 2011-07-21
- Volume
- 118
- Issue
- 3
- Pages
- 523-528
- ISSN
- 0006-4971 (ISSN-L)
- 1528-0020
- PMC
- PMC3142897
- OpenAlex
- W1980451195
- Cited by
- 80
- References
- 39
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 1 · 2021: 4 · 2020: 2 · 2019: 3 · 2018: 8 · 2017: 8 · 2016: 9 · 2015: 5 · 2014: 5 · 2013: 15 · 2012: 11
- FWCI
- 7.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Blood (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (2u10ca038926-25)
- National Cancer Institute (U10CA004919, CA-11083, CA 20319, N01 CA027057, N01 CA045807, N01 CA038926, CA 42777, N01 CA004919, N01 CA032102, CA-76429, U10-CA038926, U10CA073590, N01 CA067575, U10CA027057, U10CA020319, U10CA011083, CA073590, U10CA076429, U10CA035119, U10CA032102, U10CA042777, U10CA045807, N01 CA046441, N01 CA035119, U10CA067575, U10CA046441)
- Topics
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinoids in leukemia and cellular processes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Degradation and Inhibitors
- Keywords
- lenalidomide, acute myeloid leukemia, chromosome 5q deletion, elderly patients, myelodysplastic syndrome, monotherapy, induction therapy, maintenance therapy, relapse-free survival, overall survival, complex cytogenetics
- MeSH terms
- Lenalidomide, Aged, Aged, 80 and over, Antineoplastic Agents, Chromosome Deletion, Chromosomes, Human, Pair 5, Female, Humans, Male, Middle Aged, Thalidomide, Leukemia, Myeloid, Acute, Survival Rate, Treatment Outcome
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