Lenalidomide for the treatment of relapsed and refractory multiple myeloma

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...

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Bibliographic Details
Published in:Cancer management and research 2012, Vol.4 (default), p.253-268
Main Authors: van de Donk, Niels Wcj, Görgün, Güllü, Groen, Richard Wj, Jakubikova, Jana, Mitsiades, Constantine S, Hideshima, Teru, Laubach, Jacob, Nijhof, Inger S, Raymakers, Reinier A, Lokhorst, Henk M, Richardson, Paul G, Anderson, Kenneth C
Format: Article
Language:English
Subjects:
Cancer
Care and treatment
Cytotoxicity
Health risk assessment
Immune response
immunomodulatory drugs
Immunotherapy
lenalidomide
Multiple myeloma
refractory disease
relapse treatment
Review
Targeted cancer therapy
Testing
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Description
Summary: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.
ISSN:1179-1322
1179-1322
DOI:10.2147/CMAR.S27087