How is Revlimid used in multiple myeloma?
Revlimid is used throughout all stages of multiple myeloma.
The combination of Revlimid® (lenalidomide, Celgene) and dexamethasone, also called Revlimid-dex, is approved by the FDA for the treatment of patients with multiple myeloma. Revlimid-dex has been shown to be effective in both newly diagnosed myeloma and in disease that has relapsed or become refractory to current therapies.
Revlimid has also been shown to extend remission and survival time when used as maintenance therapy following high-dose chemotherapy and stem cell transplantation.
Further, Revlimid is also being studied in combination with other myeloma drugs as well as other new drugs in development.
What types of patients can benefit from Revlimid-dex?
Revlimid-dex has been shown to be effective in a wide range of patients including:
- Newly diagnosed/untreated myeloma and relapsed or refractory myeloma
- Older patients (>65 years old) as well as younger patients
- Patients whose disease has certain high-risk features
- Patients who previously received Thalomid® (thalidomide, Celgene), although efficacy is slightly reduced
- Patients who have received several prior therapies (heavily-pretreated)
- One study showed that some of these patients responded for a long period of time (4 or more years)
- Patients who previously received high dose chemotherapy and stem-cell transplant
- Patients with reduced kidney function (renal impairment)
- In one study, 78% of patients with moderate to severe renal impairment showed improved renal function within 4 months of treatment.
How does Revlimid work?
Revlimid works in multiple ways to slow or kill myeloma cells, although the exact way in which it works is not completely understood. It directly affects the tumor cells. It is also known to affect the blood vessels and other substances surrounding a tumor (known as the tumor microenvironment) which help to feed the cancer cell’s growth. Recently it has been shown in studies the Multiple Myeloma Research Consortium (MMRC) helped to fund that Revlimid and other IMiDs bind a protein in myeloma cells called cereblon. This binding triggers myeloma cell death. In some studies higher levels of cereblon are associated with better outcomes after treatment.