Lenalidomide plus dexamethasone is efficacious in patients with relapsed or refractory multiple myeloma

Nikhil C Munshi*, Constantine Mitsiades, Paul G Richardson and Kenneth C Anderson

This article has no abstract so we have provided the first paragraph of the full text.

Lenalidomide is a more-potent analog of thalidomide that directly induces apoptosis of MM cells and inhibits interactions between MM cells and bone-marrow-stromal cells. In addition, lenalidomide blocks both the constitutive production of cytokines and the production of cytokines induced by the binding of MM cells to bone-marrow-stromal cells.¹ On the basis of preclinical efficacy, phase I and II clinical trials have demonstrated that 25 mg lenalidomide given for 21 days of a 28-day cycle is well-tolerated and induces responses in over 30% of patients with relapsed MM. Moreover, these responses are enhanced by the addition of dexamethasone.² On the basis of these exciting results, two randomized phase III trials were conducted that compared lenalidomide plus high-dose dexamethasone with high-dose dexamethasone plus placebo in patients with relapsed or refractory MM. Both the North American study by Weber et al.³ and the international study by Dimopoulos et al. confirmed that the combination regimen was significantly superior to dexamethasone in terms of response rate, time to progression and overall survival.

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