Positive data have been reported from an open-label phase III randomized study of continuous lenalidomide in combination with dexamethasone in patients with newly diagnosed multiple myeloma who were not candidates for stem-cell transplant. In the FIRST trial, 1,623 patients ineligible for stem-cell transplant were randomly assigned to three treatment arms: lenalidomide plus low-dose dexamethasone in 28-day cycles until disease progression ; lenalidomide plus low-dose dexamethasone for 72 weeks ; or melphalan, prednisone, and thalidomide in 42-day cycles for 72 weeks .
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