High Implementation Adherence to Lenalidomide in Multiple Myeloma

Adherence to oral anticancer therapy correlates with outcome. Lenalidomide (LEN) is an oral mainstay treatment for multiple myeloma (MM), administered in 21-day/7-day (on/off) cycles. Data on LEN adherence is limited. Electronic monitoring (EM) represents the most reliable adherence assessment method.

We conducted a prospective observational study using electronic medication event monitoring (MEMS^®) in lenalidomide-naïve multiple myeloma patients to quantify adherence during on/off cycles and identify patterns of non-adherence in real-world practice. On and off cycles were determined semi-automatically. Implementation adherence was calculated as the proportion of prescribed drug taken, during each on cycle and across all on cycles. Daily adherence predictors were analyzed using logistic regression with generalized estimating equations.

Eighty-five patients were included. Median age was 68 years, 66% received LEN as a second-line treatment, 75% of patients perfectly adhered to the recommended 21/7-day on/off cycle. Median implementation adherence was 100%. Only 4% of patients had a proportion of doses taken below 90%. All doses were taken by 51% of patients, while 9% missed ≥4 doses. Among the 13 predictors investigated, only age under 80 and participation in a support group were statistically significant.

this novel assessment of LEN adherence in MM patients demonstrated high implementation adherence and cycle duration compliance.