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Review
. 2020 Aug;99(8):1709-1725.
doi: 10.1007/s00277-020-04023-4. Epub 2020 Apr 16.

The clinical management of lenalidomide-based therapy in patients with newly diagnosed multiple myeloma

Maximilian Merz  1 , Tobias Dechow  2 , Mithun Scheytt  3 , Christian Schmidt  4 , Bjoern Hackanson  5 , Stefan Knop  6
Affiliations
Review

The clinical management of lenalidomide-based therapy in patients with newly diagnosed multiple myeloma

Maximilian Merz et al. Ann Hematol. 2020 Aug.

Abstract

Lenalidomide is an integral, yet evolving, part of current treatment pathways for both transplant-eligible and transplant-ineligible patients with newly diagnosed multiple myeloma (NDMM). It is approved in combination with dexamethasone as first-line therapy for transplant-ineligible patients with NDMM, and as maintenance treatment following autologous stem cell transplantation (ASCT). Although strong clinical trial evidence has supported the integration of lenalidomide into current treatment paradigms for NDMM, applying those paradigms to individual patients and determining which patients are most likely to benefit from lenalidomide treatment are more complex. In this paper, we utilize the available clinical trial evidence to provide recommendations for patient selection and lenalidomide dosing in both the first-line setting in patients ineligible for ASCT and the maintenance setting in patients who have undergone ASCT. In addition, we provide guidance on management of those adverse events that are most commonly associated with lenalidomide treatment, and consider the optimal selection and sequencing of next-line agents following long-term frontline or maintenance treatment with lenalidomide.

Keywords: Adverse events; Lenalidomide; Multiple myeloma; Newly diagnosed; Safety.

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Conflict of interest statement

MM has received consultancy fees from Amgen and Takeda, research support from Takeda, and travel grants from Abbvie, Amgen, Takeda, and Celgene. CS has served on advisory councils/committees for Kite Gilead and Novartis, and received honoraria from Roche, Novartis, and Kite Gilead, and research support from Janssen. BH has served on advisory councils/committees for Boehringer Ingelheim, Roche, BMS, Novartis, and Abbvie. SK has received consultancy fees from Bristol-Myers Squibb, Amgen, Celgene, and Oncopeptides; served on advisory councils/committees for Bristol-Myers Squibb, Amgen, Celgene, and Oncopeptides; and received honoraria from Bristol-Myers Squibb, Amgen, Celgene, Janssen, and Oncopeptides. TD and MS declare that they have no conflict of interest.

References

    1. Blade J, Samson D, Reece D, Apperley J, Bjorkstrand B, Gahrton G, Gertz M, Giralt S, Jagannath S, Vesole D. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation. Myeloma Subcommittee of the EBMT. European Group for Blood and Marrow Transplant. Br J Haematol. 1998;102(5):1115–1123. - PubMed
    1. Rajkumar SV, Dimopoulos MA, Palumbo A, Blade J, Merlini G, Mateos MV, Kumar S, Hillengass J, Kastritis E, Richardson P, Landgren O, Paiva B, Dispenzieri A, Weiss B, LeLeu X, Zweegman S, Lonial S, Rosinol L, Zamagni E, Jagannath S, Sezer O, Kristinsson SY, Caers J, Usmani SZ, Lahuerta JJ, Johnsen HE, Beksac M, Cavo M, Goldschmidt H, Terpos E, Kyle RA, Anderson KC, Durie BG, Miguel JF. International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma. Lancet Oncol. 2014;15(12):e538–e548. - PubMed
    1. Gay F, Engelhardt M, Terpos E, Wasch R, Giaccone L, Auner HW, Caers J, Gramatzki M, van de Donk N, Oliva S, Zamagni E, Garderet L, Straka C, Hajek R, Ludwig H, Einsele H, Dimopoulos M, Boccadoro M, Kroger N, Cavo M, Goldschmidt H, Bruno B, Sonneveld P. From transplant to novel cellular therapies in multiple myeloma: European Myeloma Network guidelines and future perspectives. Haematologica. 2018;103(2):197–211. - PMC - PubMed
    1. Rajkumar SV (2018) Multiple myeloma: 2018 update on diagnosis, risk-stratification, and management. 93(8):1091–1110 - PubMed
    1. Rollig C, Knop S, Bornhauser M. Multiple myeloma. Lancet. 2015;385(9983):2197–2208. - PubMed