Myelom-Gruppe Rhein-Main

Last modified: 12 January 2013

Treatment with Lenalidomide

Lenalidomide has been approved in the United States, the EU and in Switzerland for a combination therapy with Dexamethasone in patients with multiple myeloma who already received a standard therapy. Since the end of 2005, Lenalidomide has also been approved in the USA for the treatment of patients requiring transfusions with myelodysplastic syndrome of risk class "low" or "intermediary-1" with simultaneous 5q-deletion with or without additional cytogenetic abnormalities.

Lenalidomide belongs to the IMiDs® substance class. This abbreviation stands for immunomodulatory drugs, meaning pharmaceutical substances that may modulate the immune system. IMiDs® are compounds derived from Thalidomide, which have much lesser side effects while having a same or better effectiveness.

So far, the effect mechanism of Lenalidomide has not been completely investigated. It is known however that the substance acts in different parts of the body. The immunomodulatory and antiangiogenetic properties of this substance affect the release of inflammatory substances and increase the production of antiphlogistics. The formation of blood vessels on tumours is inhibited. As a result, the supply of the cancer cells with nutrients is inhibited. Lenalidomide also has a direct effect on tumour cells by inhibiting their growth. Lenalidomide is therefore able to correct metabolic processes, which have become unbalanced in different parts of the body.

However, a therapy with Lenalidomide is also associated with side effects. In many cases, the blood picture also changes temporarily when taking Lenalidomide. The number of blood platelets may decrease (thrombocytopenia), as well as the number of white blood platelets (neutropenia). The results of the blood tests may necessitate an interruption of the therapy or a reduction of the Lenalidomide dose. Some patients require growth factors and/or blood transfusions.

Another side effect of Lenalidomide may be an increased risk of developing blood clots during treatment (vein thrombosis and lung embolism). There are no studies so far that clearly prove that a preventive therapy leads to a reduction of the probability of developing thrombosis. However, the physician may prescribe a prophylactic therapy against vein thrombosis or lung embolisms depending on the individual risk of developing blood clots. Other side effects that may be caused by taking Lenalidomide are diarrhoea, skin rashes and itching.