Lenalidomide use in multiple myeloma (Review).

Area of Science:

• Pharmacology
• Oncology
• Immunology

Background:

• Multiple myeloma (MM) is a hematologic malignancy.
• Lenalidomide is a crucial second-generation immunomodulatory drug for MM treatment.

Purpose of the Study:

• To review the pharmacological properties and pharmacokinetics of lenalidomide.
• To evaluate the efficacy and safety of lenalidomide-based treatments in MM.

Main Methods:

• Review of clinical trials and real-world studies on lenalidomide and lenalidomide-based therapies.
• Examination of lenalidomide's mechanism of action, including effects on VEGF, IL-6, and apoptosis pathways.

Main Results:

• Lenalidomide, alone or in combination (e.g., with dexamethasone, bortezomib, ixazomib, carfilzomib, daratumumab), significantly alleviates MM.
• Maintenance therapy with lenalidomide post-transplant or in non-transplant settings improves outcomes.
• Other agents like ixazomib and carfilzomib offer benefits but have specific toxicity profiles (cardiovascular events, neuropathy, infections) requiring management.

Conclusions:

• Lenalidomide is a cornerstone therapy for MM, with diverse applications and established efficacy.
• Lenalidomide-based regimens offer therapeutic benefits, but careful consideration of drug interactions and patient-specific toxicities is essential for optimal clinical application.