Lenalidomide (or Revlimid®) is chemically similar to the older drug thalidomide, but has been modified to be more potent and to produce fewer adverse side effects. As a result, it is prescribed more often than thalidomide for multiple myeloma treatment.
Lenalidomide (Revlimid®), like thalidomide, is an immunomodulatory agent that affects immune function in relation to myeloma cells and their microenvironment. Revlimid® helps activate a type of white blood cell known as T-cell lymphocytes ("killer T cells"), which work to eliminate myeloma cells.
Myeloma cells, like normal cells, require nutrients and oxygen to grow and reproduce. Lenalidomide prevents myeloma cells from developing new blood vessels, which cuts of their supply of nutrients and oxygen. Without these, myeloma tumors die off. Revlimid® also prevents myeloma cells from attaching themselves to bone marrow cells and producing cytokines (growth factors). These factors combined can stop or slow the progression of multiple myeloma.
Lenalidomide is given in the form of capsules. Normally, patients take capsules every day for three weeks, with a one-week rest period in between each treatment cycle. Capsules should be taken at the same time every day; a typical dose is 25 mg per day.
The duration of treatment depends on how soon the drug takes effect. Doctors prescribe Revlimid® for patients in all stages of the disease. Lenalidomide is often combined with a corticosteroid drug called dexamethasone.
Lenalidomide is associated with some side effects, including:
Although many of these side effects are the same as those associated with taking thalidomide, they occur less frequently with Revlimid® treatment.
Birth defects, typically structural, are one of the most serious side effects of this treatment. Both you and your partner should take precautions to ensure you don’t get pregnant while you’re taking this drug.
When you take Revlimid® with dexamethasone, additional side effects may include:
Revlimid® combined with a low dose of dexamethasone often produces fewer side effects than Revlimid® alone, and is often recommended for patients over 65 years of age.
Several large-scale studies have shown that a multi-drug therapy combining Revlimid® and dexamethasone produces treatment response rates that are more than double that of treatment with dexamethasone alone. Patient survival rates are also significantly better with combination drug treatment.
Cancer Research UK. (2010). Biological therapy for myeloma. Retrieved October 4, 2010, from http://www.cancerhelp.org.uk/type/myeloma/treatment/biological-therapy-for-myeloma
International Myeloma Foundation. (2009). Understanding Revlimid®. Retrieved October 4, 2010, from http://myeloma.org/pdfs/u-rev_eng_f2-web.pdf
Mayo Foundation for Medical Education and Research. (2009). Multiple myeloma: Treatment and drugs. Retrieved October 4, 2010, from http://www.mayoclinic.com/health/multiple-myeloma/DS00415/DSECTION=treatments-and-drugs
Multiple Myeloma Research Foundation. (n.d.). Revlimid. Retrieved October 4, 2010, from http://www.themmrf.org/living-with-multiple-myeloma/patients-starting-treatment/treatment-options/revlimid.html
Myeloma Canada. (2010). Treatment options. Retrieved October 4, 2010, from http://www.myelomacanada.ca/en/treatment_options.htm
Seattle Cancer Care Alliance. (2010). New treatments for myeloma. Retrieved October 4, 2010, from http://www.seattlecca.org/diseases/new-treatments.cfm