title: Optimizing the use of lenalidomide in relapsed or refractory multiple myeloma: consensus statement.
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.
authors.affiliation: Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, Athens, Greece. mdimop@med.uoa.gr
authors.forename: M A
authors.initials: MA
authors.lastname: Dimopoulos
authors.forename: A
authors.initials: A
authors.lastname: Palumbo
authors.forename: M
authors.initials: M
authors.lastname: Attal
authors.forename: M
authors.initials: M
authors.lastname: Beksaç
authors.forename: F E
authors.initials: FE
authors.lastname: Davies
authors.forename: M
authors.initials: M
authors.lastname: Delforge
authors.forename: H
authors.initials: H
authors.lastname: Einsele
authors.forename: R
authors.initials: R
authors.lastname: Hajek
authors.forename: J-L
authors.initials: JL
authors.lastname: Harousseau
authors.forename: F Leal
authors.initials: FL
authors.lastname: da Costa
authors.forename: H
authors.initials: H
authors.lastname: Ludwig
authors.forename: U-H
authors.initials: UH
authors.lastname: Mellqvist
authors.forename: G J
authors.initials: GJ
authors.lastname: Morgan
authors.forename: J F
authors.initials: JF
authors.lastname: San-Miguel
authors.forename: S
authors.initials: S
authors.lastname: Zweegman
authors.forename: P
authors.initials: P
authors.lastname: Sonneveld
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D019008:Drug Resistance, Neoplasm / Q000187:drug effects*; D006801:Humans; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy*; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D000970:Antineoplastic Agents; D013792:Thalidomide; D000077269:Lenalidomide