Lenalidomide in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma

Palumbo, Antonio; Dimopoulos, Meletios; Miguel, Jesus San; Harousseau, Jean-Luc; Attal, Michel; Hussein, Mohamad; Knop, Stefan; Ludwig, Heinz; von Lilienfeld-Toal, Marie; Sonneveld, Pieter

doi:10.1016/j.blre.2008.07.003

« PreviousBlood Reviews
Volume 23, Issue 2 , Pages 87-93, March 2009

Lenalidomide in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma

Antonio Palumbo
- Divisione di Ematologia dell’Università di Torino, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
- Corresponding author. Tel.: +39 0116336107; fax: +39 0116963737.
Meletios Dimopoulos
- Department of Clinical Therapeutics, University of Athens School of Medicine, Athens, Greece
- Tel.: +30 210 3381541; fax: +30 210 3381511.
Jesus San Miguel
- Department of Hematology, University Hospital of Salamanca, Salamanca, Spain
- Tel.: +34 923291384.
Jean-Luc Harousseau
- Hôtel-Dieu Hospital, Nantes, France
- Tel.: +33 2 40 08 32 71; fax: +33 2 40 08 32 50.
Michel Attal
- Division of Hematology, Centre Hospitalier Université de Purpan, Toulouse, France
- Tel.: +33 (05) 61777784; fax: +33 (05) 61777541.
Mohamad Hussein
- H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
- Tel.: +1 813 745 8090; fax: +1 813 979 3071.
Stefan Knop
- Department of Hematology and Oncology, University Hospital, Würzburg, Germany
- Tel.: +49 931 201 0; fax: +49 931 201 70281.
Heinz Ludwig
- Wilhelminenspital, Vienna, Austria
- Tel.: +43 1491502101; fax: +43 1491501009.
Marie von Lilienfeld-Toal
- BMTU, Gledhow Wing, St. James’s University Hospital, Leeds Teaching Hospitals, Leeds, UK
- Tel.: +44 228 28715507; fax: +44 228 28714319.
Pieter Sonneveld
- Department of Hematology, Erasmus Medical Center, Rotterdam, The Netherlands
- Tel.: +31 10 463 3123; fax: +31 10 463 5814.

published online 09 September 2008.

Summary

Recent studies have shown a clinical benefit of lenalidomide, an oral immunomodulatory drug, plus dexamethasone in patients with relapsed/refractory multiple myeloma (MM). The most common grade 3–4 adverse events were cytopenias, fatigue, muscle cramps, rash, infection, insomnia, and venous thromboembolism. Lenalidomide in combination with dexamethasone has been approved by the United States Food and Drug Administration and the European Medicines Agency for the treatment of patients with MM who have received at least one prior therapy. An expert panel reviewed the efficacy and toxicity of lenalidomide plus dexamethasone, and provided recommendations on the management of patients receiving this treatment. Patient selection is straightforward, as prognostic factors do not appear to heavily influence efficacy. In addition, the panel agreed on strategies for the management of side effects. The recommendations presented here will aid the safe administration of lenalidomide, and avoid unnecessary dose reduction and discontinuation, thus assuring the best efficacy of treatment.

Keywords: Dexamethasone, Lenalidomide, Multiple myeloma, Cytopenia, Venous thromboembolism