The National Institute for Health and Care Excellence (NICE) recommends lenalidomide (Revlimid) plus dexamethasone as a treatment option for adults with multiple myeloma.
Lenalidomide in combination with dexamethasone is recommended for the treatment of multiple myeloma in adults who have previously received one therapy, which included bortezomib.
Thalidomide-based therapy is the first-line treatment for multiple myeloma, bortezomib being the alternative for those who cannot have thalidomide. The second treatment after bortezomib is usually cytotoxic chemotherapy. However, evidence indicates that lenalidomide plus dexamethasone may be more effective than cytotoxic chemotherapy.
Lenalidomide in combination with dexamethasone is also recommended for the treatment of previously untreated multiple myeloma in adults not eligible for a stem cell transplant, if thalidomide is contraindicated or not tolerated.
In previously untreated patients who are unable to have thalidomide, evidence suggests that lenalidomide plus dexamethasone could significantly improve survival compared with bortezomib.
Recommended starting dose for lenalidomide is 25 mg administered orally once daily on days 1 to 21 of repeated 28-day cycles.
The drug is to be used only when provided by the company in agreement with the commercial arrangement. The recommendations should not affect patients whose treatment with the drug was started before the publication of the guidance.