Common brand names

• Revlimid

How it is administered

Lenalidomide is taken by mouth as a capsule. It comes in various strengths (2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg). The capsules should be swallowed whole with water, at about the same time each day, and can be taken with or without food. Do not open, break, or chew the capsules. If you miss a dose, you can take it up to 12 hours after your usual time; otherwise, skip the missed dose and take your next dose at the regular time. Do not take two doses at once.

How it works

Lenalidomide is a type of medicine called an immunomodulatory agent. It works by affecting the immune system and other processes in the body to help slow or stop the growth of cancer cells. Specifically, lenalidomide targets a protein called cereblon, which is part of a complex that helps regulate the breakdown of certain proteins within cells. When lenalidomide binds to cereblon, it leads to the destruction of proteins that are important for cancer cell survival.

Lenalidomide also helps the immune system recognize and attack cancer cells by increasing the activity and number of certain immune cells, such as T cells and natural killer (NK) cells. It can also reduce the production of substances that promote inflammation and cancer growth. In blood cancers like large B-cell lymphoma, these actions can help control the disease and improve outcomes, especially when used in combination with other treatments.

Who should take it

Lenalidomide is used in adults for several blood cancers, including certain types of lymphoma. For lymphoma, it is specifically approved for mantle cell lymphoma (MCL) that has relapsed or progressed after two prior therapies (one of which included bortezomib), and for previously treated follicular lymphoma and marginal zone lymphoma in combination with rituximab.

While lenalidomide is not specifically approved for large B-cell lymphoma, it may be used in certain situations as part of clinical trials or as determined by your doctor. It is also used in multiple myeloma and myelodysplastic syndromes. Your doctor will decide if lenalidomide is right for you based on your type of cancer, previous treatments, and overall health.

Who should not take it

Lenalidomide should NOT be taken by women who are pregnant, as it can cause severe birth defects or death to an unborn baby. Women of childbearing potential must use two forms of birth control and have regular pregnancy tests before and during treatment. Men taking lenalidomide must use condoms during sexual contact with women who can become pregnant, even if they have had a vasectomy, and must not donate sperm.

People who have had severe allergic reactions to lenalidomide (such as angioedema, Stevens-Johnson syndrome, or toxic epidermal necrolysis) should not take it. If you have severe liver or kidney problems, or other serious health conditions, your doctor will determine if lenalidomide is safe for you.

Commonly used with

For lymphoma, lenalidomide is often used in combination with rituximab, especially for follicular lymphoma and marginal zone lymphoma. In multiple myeloma, it is commonly combined with dexamethasone and sometimes with other drugs such as bortezomib. Your doctor will choose the best combination based on your specific cancer and treatment history.

Commonly tested with

Lenalidomide has been tested in combination with rituximab for follicular lymphoma and marginal zone lymphoma, and with dexamethasone for multiple myeloma. It has also been studied with other agents such as bortezomib, melphalan, and prednisone in various clinical trials for blood cancers. In large B-cell lymphoma, it may be tested as part of research protocols or in combination with other targeted therapies.