Lenalidomide (Revlimid)
General information
Class/mechanism: Second-generation immunomodulatory drug (IMiD) similar to Thalidomide (Thalomid); mechanism not fully understood. Lenalidomide's mechanism may involve immunomodulatory, antiinflammatory, and antiangiogenic effects and suppression of tumor necrosis factor-alpha (TNF-α) from peripheral blood mononuclear cells. It has been observed to inhibit cells with the 5q deletion in myelodysplastic syndromes. It has also been seen in vitro to inhibit cyclooxygenase-2 (COX-2) expression, but not COX-1.[1][2][3][4]
Route: PO
Extravasation: n/a
- Use of Lenalidomide (Revlimid) requires participation the Revlimid REMS program.[4]
For conciseness and simplicity, HemOnc.org currently will focus on treatment regimens and not list information such as: renal/hepatic dose adjustments, metabolism (including CYP450), excretion, monitoring parameters (although this will be considered for checklists), or manufacturer. Instead, for the most current information, please refer to your preferred pharmacopeias such as Micromedex, Lexicomp, UpToDate (courtesy of Lexicomp), or the prescribing information.[1]
Diseases for which it is used
- Adult T-cell leukemia-lymphoma
- Chronic lymphocytic leukemia (CLL/SLL)
- Chronic myelomonocytic leukemia
- Cutaneous T-cell lymphoma
- Diffuse large B-cell lymphoma
- Follicular lymphoma
- Hodgkin lymphoma
- Light-chain (AL) amyloidosis
- Mantle cell lymphoma
- Marginal zone lymphoma
- Multiple myeloma
- Myelodysplastic syndrome
- Myelofibrosis
- Peripheral T-cell lymphoma
- Plasma cell leukemia
- POEMS
- Polycythemia vera
- Transformed lymphoma
- Waldenström macroglobulinemia
Significant side effects
Thrombosis
- 2006 (two simultaneously published NEJM letters to the editor): link to original article PubMed link to letter #1 PubMed link to letter #2
- 2011: Larocca A, Cavallo F, Bringhen S, Di Raimondo F, Falanga A, Evangelista A, Cavalli M, Stanevsky A, Corradini P, Pezzatti S, Patriarca F, Cavo M, Peccatori J, Catalano L, Carella AM, Cafro AM, Siniscalchi A, Crippa C, Petrucci MT, Yehuda DB, Beggiato E, Di Toritto TC, Boccadoro M, Nagler A, Palumbo A. Aspirin or enoxaparin thromboprophylaxis for patients with newly diagnosed multiple myeloma treated with lenalidomide. Blood. 2012 Jan 26;119(4):933-9. Epub 2011 Aug 11. link to original article PubMed
Patient drug information
- Lenalidomide (Revlimid) package insert[1]
- Lenalidomide (Revlimid) patient medication guide[5]
- Lenalidomide (Revlimid) patient drug information (Chemocare)[6]
- Lenalidomide (Revlimid) patient drug information (UpToDate)[7]
History of changes in FDA indication
- 12/28/2005: FDA approved for patients with "transfusion-dependent anemia due to low- or intermediate-1-risk myelodysplastic syndromes (MDS) associated with a deletion 5q abnormality with or without additional cytogenetic abnormalities."[1]
- 6/29/2006: FDA approved for treatment of patients with "multiple myeloma (MM), in combination with dexamethasone, in patients who have received at least one prior therapy.][1]
- 6/5/2013: FDA approved for patients with "mantle cell lymphoma (MCL) whose disease has relapsed or progressed after two prior therapies, one of which included bortezomib."[1]
- 2/22/2017: FDA approval expanded "as maintenance therapy for patients with multiple myeloma following autologous stem cell transplant."
Also known as
- Code names: CC-5013, IMiD-1, NSC-703813
- Brand names: Kabillon, Lenalid, Lenangio, Lenmid, Lenome, Lenzest, MyeloSar, Revlimid
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Lenalidomide (Revlimid) package insert
- ↑ Lenalidomide (Revlimid) package insert (locally hosted backup)
- ↑ Revlimid manufacturer's site
- ↑ 4.0 4.1 Revlimid REMS program
- ↑ Lenalidomide (Revlimid) patient medication guide
- ↑ Lenalidomide (Revlimid) patient drug information (Chemocare)
- ↑ Lenalidomide (Revlimid) patient drug information (UpToDate)
- Drugs
- Oral medications
- Immunomodulatory drugs (IMiDs)
- Adult T-cell leukemia-lymphoma medications
- Chronic lymphocytic leukemia medications
- Chronic myelomonocytic leukemia medications
- Cutaneous T-cell lymphoma medications
- Diffuse large B-cell lymphoma medications
- Follicular lymphoma medications
- Hodgkin lymphoma medications
- Light-chain (AL) amyloidosis medications
- Mantle cell lymphoma medications
- Marginal zone lymphoma medications
- Multiple myeloma medications
- Myelodysplastic syndrome medications
- Myelofibrosis medications
- Peripheral T-cell lymphoma medications
- Plasma cell leukemia medications
- POEMS medications
- Polycythemia vera medications
- Transformed lymphoma medications
- Waldenström macroglobulinemia medications
- REMS program
- FDA approved in 2005