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Optimizing the use of lenalidomide in relapsed or refractory multiple myeloma: consensus statement

Leukemia volume 25, pages 749–760 (2011)Cite this article

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Abstract

An expert panel convened to reach a consensus regarding the optimal use of lenalidomide in combination with dexamethasone (Len/Dex) in patients with relapsed or refractory multiple myeloma (RRMM). On the basis of the available evidence, the panel agreed that Len/Dex is a valid and effective treatment option for most patients with RRMM. As with other therapies, using Len/Dex at first relapse is more effective regarding response rate and durability than using it after multiple salvage therapies. Len/Dex may be beneficial regardless of patient age, disease stage and renal function, although the starting dose of lenalidomide should be adjusted for renal impairment and cytopenias. Long-term treatment until there is evidence of disease progression may be recommended at the best-tolerated doses of both lenalidomide and dexamethasone. Recommendations regarding the prevention and management of adverse events, particularly venous thromboembolism and myelosuppression, were provided on the basis of the available evidence and practical experience of panel members. Ongoing trials will provide more insight into the effects of continuous lenalidomide-based therapy in myeloma.

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Acknowledgements

We received support regarding linguistic improvement, artwork and formatting of the manuscript from Excerpta Medica, funded by Celgene Corporation. We are fully responsible for content and editorial decisions for this manuscript.

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Authors and Affiliations

  1. Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, Athens, Greece,

    M A Dimopoulos

  2. Divisione di Ematologia dell’Università di Torino, Azienda Ospedaliera S Giovanni Battista, Turin, Italy,

    A Palumbo

  3. Division of Hematology, Hôpital Purpan, Toulouse, France

    M Attal

  4. Department of Hematology, Ankara University, Ankara, Turkey

    M Beksaç

  5. Institute of Cancer Research, Royal Marsden Hospital, London, UK

    F E Davies & G J Morgan

  6. Department of Hematology, University Hospital Leuven, Leuven, Belgium

    M Delforge

  7. Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany

    H Einsele

  8. Department of Internal Medicine and Hematooncology, Faculty of Hospital Brno and Babak Research Institute, Faculty of Medicine, Masaryk University, Brno-město, Czech Republic

    R Hajek

  9. Department of Clinical Haematology, Centre René Gauducheau, Saint-Herblain, France

    J-L Harousseau

  10. Bone Marrow Transplantation Unit, Instituto Português de Oncologia, Lisbon, Portugal

    F Leal da Costa

  11. First Department of Medicine, Center for Oncology and Hematology, Vienna, Austria

    H Ludwig

  12. Department of Hematology, University Hospital, Gothenburg, Sweden

    U-H Mellqvist

  13. Hospital Universitario de Salamanca, CIC, IBMCC (USAL-CSIC), Salamanca, Spain

    J F San-Miguel

  14. Department of Hematology, VU University Medical Center, Amsterdam, Netherlands

    S Zweegman

  15. Department of Hematology, University Hospital Rotterdam, Rotterdam, Netherlands

    P Sonneveld

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on behalf of the European Myeloma Network

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Correspondence to M A Dimopoulos.

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Competing interests

MAD had a consultant role for, and has received honoraria from, Celgene. AP is a speaker for, advisory board member of, and has received a research grant from, Celgene. HL has received honoraria from, and is a speakers’ bureau member of Celgene, Mundipharma and Ortho Biotech. MA is an advisory board member of Celgene. MB is a speakers’ bureau member of Celgene and Janssen-Cilag, and has received honorarium from Celgene. HE has received honoraria from Celgene. FLC had a consultant role for, and received honoraria from, Celgene, Amgen, MSD and Janssen-Cilag. U-HM is an advisory board member of Celgene and has received a research grant from Janssen-Cilag. FED has served as a speakers’ bureau member of Celgene and Ortho Biotech, and has participated in advisory boards of Celgene, Ortho Biotech and Novartis. J-LH has received consulting and lecture fees from Celgene. MD is an advisory board member of, and has received honoraria as a speaker from, Celgene. PS is an advisory board member of Celgene, Janssen-Cilag and Onyx, and has received research funding from Celgene and Janssen-Cilag. RH has received reimbursement of expenses and honoraria for attending symposia from Celgene. JFS-M has received compensation as a scientific advisory board member from Millennium, Celgene and Janssen-Cilag. SZ has received compensation as a scientific advisory board member of Celgene. GJM received payment for lectures including service on speakers’ bureaus from Novartis, Celgene and Ortho Biotech.

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MAD, AP and PS planned this review; MAD wrote the first draft of the manuscript. All authors reviewed and commented on the draft and approved the final manuscript.

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Dimopoulos, M., Palumbo, A., Attal, M. et al. Optimizing the use of lenalidomide in relapsed or refractory multiple myeloma: consensus statement. Leukemia 25, 749–760 (2011). https://doi.org/10.1038/leu.2011.3

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  • DOI: https://doi.org/10.1038/leu.2011.3

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