Secondary Primary Malignancies in Multiple Myeloma: An Old Nemesis Revisited

Table 2

Incidence of SPMs with lenalidomide (Len)-based therapy in selected trial cohorts based on retrospective or post hoc analyses.

Trial/Location	Reference	𝑁	F/u	Patient population	Treatment	Invasive SPMs	Cumulative incidence of SPMs^a  (%)	IR^b	SIR^c  (95% CI)	Types (number of cases)
PMH	[60]	230	N/A	RRMM^d	Len-based	6^f	2.6	Not reported	Not reported	MDS/AML
Cornell	[59]	68	>5 yrs	NDMM^e	BiRD^g	5	7.4^h	2.85	1.36	MDS/AML (0), solid (5)
MM009-010	[58]	704	48 mo	RRMM	Len/dex	8	2.3	1.71	N/A	MDS (2), AML (0), solid (6), B-cell (0)
Pooled data	[58]	3839	N/A	RRMM	Len-based	57	1.5	2.35	0.77 (0.43–1.28)	MDS (8), AML (1), B-cell (2), solid (46)

^aExcluding nonmelanoma skin cancers.
^bIncidence rate per 100 person-years at risk.
^cStandardized incidence ratio (i.e., ratio of observed/expected rates).
^dRelapsed and/or refractory multiple myeloma.
^eNewly diagnosed multiple myeloma.
^fOnly MDS/AML was reported.
^gClarithromycin, lenalidomide, and dexamethasone.