Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, Athens, Greece.
Crit Rev Oncol Hematol. 2013 Oct;88 Suppl 1:S23-35. doi: 10.1016/j.critrevonc.2013.05.013. Epub 2013 Jun 28.
Lenalidomide is a distinct second-generation immunomodulatory drug with multiple anticancer and immunomodulatory effects against hematologic malignancies, in particular multiple myeloma (MM). Dexamethasone synergistically enhances the anticancer effects of lenalidomide, and the combination of lenalidomide and dexamethasone (Len/Dex) is approved for the treatment of patients with relapsed and/or refractory MM. Results from pivotal phase III trials in this setting have demonstrated that Len/Dex extends overall survival compared with dexamethasone alone. Optimal clinical benefits are seen when Len/Dex is initiated at first relapse and continued, beyond best treatment response, until disease progression. Lenalidomide based regimens are also effective as induction therapy in patients with newly diagnosed MM. Importantly, lenalidomide has a predictable and manageable tolerability profile, with minimal neurotoxicity, allowing long-term administration. As the paradigm of myeloma disease continues to change, future studies will determine the efficacy of lenalidomide in novel combinations with potentially complimentary agents.
来那度胺是一种独特的第二代免疫调节药物，具有针对血液系统恶性肿瘤，特别是多发性骨髓瘤（MM）的多种抗癌和免疫调节作用。地塞米松与来那度胺协同增强抗癌作用，来那度胺联合地塞米松（Len/Dex）获批用于治疗复发和/或难治性 MM 患者。该治疗方案的关键性 III 期临床试验结果表明，与单独使用地塞米松相比，Len/Dex 可延长总生存期。当首次复发时开始并持续使用 Len/Dex，直至疾病进展，超越最佳治疗反应，可获得最佳临床获益。来那度胺为基础的方案也可作为新诊断 MM 患者的诱导治疗。重要的是，来那度胺具有可预测且可控的耐受性，神经毒性最小，可长期给药。随着骨髓瘤疾病模式的持续变化，未来的研究将确定来那度胺与潜在互补药物联合使用的疗效。
