Late-onset remission in patients with mucosa-associated lymphoid tissue (MALT) lymphoma treated with thalidomide or lenalidomide may be a common phenomenon, a study published online ahead of print in the journal The Oncologist has shown.1

Thalidomide and lenalidomide are immunomodulatory drugs (IMiDs) that have been tested for the treatment of MALT lymphoma. Although lenalidomide shows promising activity, no long-term results of either drug are available. Researchers at Medical University Vienna, in Vienna, Austria, noted late-onset remission in individual patients at their institution and sought to review cases of patients treated with IMiDs for long-term outcomes.

The retrospective analysis identified 18 patients who had been treated with lenalidomide and 7 patients who had been treated with thalidomide who were available for long-term outcomes assessments. Standardized follow-up protocol was used for all patients.

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Of the 25 patients, a delayed-onset response without further treatment was seen in 7 patients. The initial outcomes of partial remission or stable disease improved to complete remission or partial remission in 4 patients after a median of 19.5 months. In addition, ongoing shrinkage of the target lesion was seen in 2 patients in 47.4+ and 43.5+ months, respectively, and durable disease stabilization was achieved for 16.2+ months in 1 patient.

The median time to best response in all patients was 7.3 months. Of the 25 patients, 23 were still alive after a median follow-up of 46 months.

The researchers conclude that clinicians should allow sufficient follow-up time after treatment to assess the full effect of therapy before initiating further therapy to avoid overtreatment.


1. Kiesewetter B, Troch M, Mayerhoefer ME, Dolak W, Simonitsch-Klupp I, Raderer M. Delayed efficacy after treatment with lenalidomide or thalidomide in patients with mucosa-associated lymphoid tissue lymphoma [published online ahead of print November 30, 2015]. Oncologist. doi:10.1634/theoncologist.2015-0176.