How it is administered

Lenalidomide is taken by mouth as a capsule. It comes in several strengths (2.5 mg, 5 mg, 10 mg, 15 mg, 20 mg, and 25 mg). The capsule should be swallowed whole with water, at about the same time each day, with or without food. Do not open, break, or chew the capsules.

How it works

Lenalidomide is a type of medicine called an immunomodulatory agent. It is a thalidomide analogue with anti-cancer, immune-modulating, and anti-angiogenic (blocks new blood vessel growth) properties. Lenalidomide works by targeting a protein called cereblon, which is part of a complex that helps regulate the breakdown of certain proteins in cells. When lenalidomide binds to cereblon, it leads to the destruction of proteins that cancer cells need to survive and grow.

In multiple myeloma, lenalidomide helps slow or stop the growth of cancerous plasma cells in the bone marrow. It also boosts the immune system by increasing the number and activity of T-cells and natural killer (NK) cells, which can attack cancer cells. Additionally, lenalidomide reduces the production of substances that promote inflammation and cancer cell survival. When used with dexamethasone, it has a synergistic effect, meaning the two drugs work better together than alone.

Who Should take it

Lenalidomide is indicated for adults with multiple myeloma in two main situations:

1. In combination with dexamethasone for the treatment of multiple myeloma.
2. As maintenance therapy after autologous hematopoietic stem cell transplantation (auto-HSCT).

It is also used for other blood cancers, such as certain types of myelodysplastic syndromes and lymphomas, but for multiple myeloma, these are the main uses. Your doctor will decide if lenalidomide is right for you based on your specific diagnosis, previous treatments, and overall health.

Who should not take it

Lenalidomide should NOT be taken by:

• Women who are pregnant or may become pregnant, as it can cause severe birth defects or death of an unborn baby.
• People with a history of severe allergic reactions (such as angioedema, Stevens-Johnson syndrome, or toxic epidermal necrolysis) to lenalidomide.

If you are of childbearing potential, you must use two reliable forms of birth control and have regular pregnancy tests. Men taking lenalidomide must use condoms during sexual contact with women of childbearing potential and must not donate sperm. Blood donation is also not allowed during and for 4 weeks after stopping lenalidomide.

Commonly used with

For multiple myeloma, lenalidomide is most commonly used with dexamethasone, a corticosteroid that helps reduce inflammation and also has anti-cancer effects. In some cases, it may be combined with other agents as part of a treatment regimen, especially in clinical trials or specific patient situations.

Commonly tested with

Lenalidomide has been tested in combination with dexamethasone in multiple clinical studies for multiple myeloma. It has also been studied with other agents such as melphalan, prednisone, thalidomide, and rituximab (for other blood cancers). In maintenance therapy, it is used alone after stem cell transplant.