Lenalidomide for the treatment of relapsed and refractory multiple myeloma

Niels W.C.J. van de Donk, Güllü Görgün, Richard W.J. Groen, Jana Jakubikova, Constantine S. Mitsiades, Teru Hideshima, Jacob Laubach, Inger S. Nijhof, Reinier A. Raymakers, Henk M. Lokhorst, Paul G. Richardson, Kenneth C. Anderson

Research output: Contribution to journalReview article

26 Scopus citations

Abstract

Lenalidomide is an amino-substituted derivative of thalidomide with direct antiproliferative and cytotoxic effects on the myeloma tumor cell, as well as antiangiogenic activity and immunomodulatory effects. Together with the introduction of bortezomib and thalidomide, lenalidomide has significantly improved the survival of patients with relapsed and refractory myeloma. The most common adverse events associated with lenalidomide include fatigue, skin rash, thrombocytopenia, and neutropenia. In addition, when lenalidomide is combined with dexamethasone or other conventional cytotoxic agents, there is an increase in the incidence of venous thromboembolic events. There is now evidence that continued treatment with lenalidomide has a significant impact on survival by improving the depth and duration of response. This highlights the value of adverse event management and appropriate dose adjustments to prevent toxicity, and of allowing continued treatment until disease progression. In this review, we will discuss the different lenalidomide-based treatment regimens for patients with relapsed/refractory myeloma. This is accompanied by recommendations of how to manage and prevent adverse events associated with lenalidomide-based therapy.

Original languageEnglish (US)
Pages (from-to)253-268
Number of pages16
JournalCancer Management and Research
Volume4
Issue number1
DOIs
StatePublished - Aug 13 2012

Keywords

  • Immunomodulatory drugs
  • Lenalidomide
  • Multiple myeloma
  • Refractory disease
  • Relapse treatment

ASJC Scopus subject areas

  • Oncology

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  • Cite this

    van de Donk, N. W. C. J., Görgün, G., Groen, R. W. J., Jakubikova, J., Mitsiades, C. S., Hideshima, T., Laubach, J., Nijhof, I. S., Raymakers, R. A., Lokhorst, H. M., Richardson, P. G., & Anderson, K. C. (2012). Lenalidomide for the treatment of relapsed and refractory multiple myeloma. Cancer Management and Research, 4(1), 253-268. https://doi.org/10.2147/CMAR.S27087