Lenalidomide Cc5013 Revlimid

Lenalidomide is a member of a class of thalidomide analogues called immunmodulatory drugs, or IMiDs. In vitro, lenalidomide modulates cytokine production and T-lymphocyte stimulation at least 100 times more potently than thalidomide.118, 119 Phase I trials in relapsed-refractory patients using doses ranging from 5 mg/day to 50 mg/day have shown response rates of 40-71%, even in patients previously treated with thalidomide.120, 121 The toxicity profile of lenalidomide is very different than that of thalidomide, with thrombocytopenia and neutropenia predominating, and essentially no sedation, constipation, or neuropathy. The response rate among 34 patients with newly diagnosed MM treated with lenalidomide 25 mg daily for 21 out of every 28 days with pulse dexamethasone (40 mg/day on days 1-4, 9-12, 17-20) was 91% (CR 6%).122 ECOG has completed accrual to a large randomized study of lenalidomide with two different doses of dexamethasone, and the Southwest Oncology Group is currently conducting a 500-person randomized, double-blinded study comparing dexamethasone to dexamethasone plus lenalidomide (LD). The results of these two studies will establish whether LD could be an appropriate front-line regimen for patients with MM.

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