Lenalidomide in multiple myeloma

Abstract

In the last couple of years major progress has been made in the treatment of multiple myeloma (MM) through the introduction of novel agents like thalidomide, lenalidomide, bortezomib and pomalidomide, mostly in combination with autologous stem cell transplantation. Lenalidomide, a second-generation immunomodulatory agent with antitumor and immunomodulatory effects against MM, in combination with dexamethasone was proven to show significant clinical benefits (overall survival and progression-free survival) in Phase III trials either as induction or as maintenance therapy. With a manageable toxicity profile, lenalidomide seems to be an attractive agent in the treatment of MM. Here, we discuss the present data and research on lenalidomide in the treatment of MM.

Keywords:

• adverse effects
• drug profile
• immunomodulation
• immunotherapy
• lenalidomide
• myeloma
• pharmacokinetics

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Lenalidomide is a second-generation immunomodulatory agent with antitumor and immunomodulatory effects against multiple myeloma.

• Lenalidomide is an effective agent for the treatment of patients with newly diagnosed MM or relapsed/refractory MM and shows significant clinical benefits with improved overall survival and progression-free survival.

• Lenalidomide can be used both in induction and in maintenance therapy as single agent or in combination with other new agents or chemotherapeutical components.

• Lenalidomide has adverse effects (e.g., hematologic toxicities, venous thromboembolic complications and peripheral neuropathy), which have to be monitored regularly, anticoagulation is recommended.

• Dosage adjustments are recommended in MM patients with moderate-to-severe renal impairment.

• Due to a manageable toxicity profile, lenalidomide is usually well tolerated by patients and thus suitable for long-term use.

Notes