Meta-analysis of second primary malignancies in patients with hematological cancers treated with lenalidomide

Previous meta-analyses identified an association between lenalidomide therapy and second primary malignancies (SPMs) in patients with multiple myeloma (MM). Systematic review and meta-analysis of 38 trials (14,508 patients) found that the risk ratio of SPM with lenalidomide for MM was 1.42 (95% CI 1.09-1.84) while there was no increase in SPM with lenalidomide for lymphoma (0.90; 0.76-1.08) or myelodysplastic syndrome (0.96; 0.23-3.97). Among the 38 trials, 21 (55%) had low risk of bias, 12 (32%) had inclear risk of bias, and 5 (13%) had high risk of bias. The authors conclude that lenalidomide-induced SPM seem to occur exclusively in patients with MM.