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Systemic Anti-Cancer Therapy Regimen Library

Home > PCN MM - LenBorDex [lenalidomide, bortezomib, and dexamethasone] induction

PCN MM - LenBorDex [lenalidomide, bortezomib, and dexamethasone] induction

Treatment Overview

If autologous stem cell transplant is planned, early stem cell mobilisation is advised between cycles 2 to 4 due to negative impact of lenalidomide on stem cell yield.

Cycles 1 to 6 - 28 days

Cycle length:
28

Bortezomib: ONLY to be administered subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Cycle details

Cycles 1 to 6 - 28 days

Medication Dose Route Days Max Duration
dexamethasone * 40 mg flat dosing oral administration 1, 8, 15,
22
lenalidomide * 25 mg Once daily oral administration 1 to 21
bortezomib * 1.5 mg/m² subcutaneous injection 1, 8, 15,
22

Bortezomib: ONLY to be administered subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Full details

Cycles 1 to 6 - 28 days

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:
bortezomib * 1.5 mg/m² subcutaneous injection
Instructions:

ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Day: 2

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 3

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 4

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 5

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 6

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 7

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 8

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:
bortezomib * 1.5 mg/m² subcutaneous injection
Instructions:

ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Day: 9

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 10

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 11

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 12

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 13

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 14

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 15

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:
bortezomib * 1.5 mg/m² subcutaneous injection
Instructions:

ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Day: 16

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 17

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 18

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 19

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 20

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 21

Medication Dose Route Max duration Details
lenalidomide * 25 mg Once daily oral administration
Instructions:
  • Take each dose on an empty stomach—at least one hour before OR two hours after food.
  • Swallow whole, do not crush or chew.
Additional details:

Day: 22

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.
bortezomib * 1.5 mg/m² subcutaneous injection
Instructions:

ONLY administer subcutaneously or intravenously as per protocol. Other routes of administration may be fatal.

Additional details

Section 1: Teratogenic effects

All patients must fulfil the requirements of the pregnancy prevention risk management programme to ensure pregnant women are not exposed to lenalidomide.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis recommended
Emetogenicity: Minimal to low
Gastroprotection: Gastroprotection may be considered
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended
Thromboprophylaxis: Thromboprophylaxis is recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Rosiñol L, Oriol A, Rios R, et al. Bortezomib, lenalidomide, and dexamethasone as induction therapy prior to autologous transplant in multiple myeloma. Blood. 2019 Oct 17;134(16):1337-1345., PMID: 31484647

Durie BGM, Hoering A, Sexton R, et al. Longer term follow-up of the randomized phase III trial SWOG S0777: bortezomib, lenalidomide and dexamethasone vs. lenalidomide and dexamethasone in patients (Pts) with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant (ASCT). Blood Cancer J. 2020 May 11;10(5):53., PMID: 32393732

Pfizer New Zealand Ltd. DBL™ Bortezomib New Zealand Medicine Data Sheet 5 June 2025. https://www.medsafe.govt.nz/profs/datasheet/d/dblbortezomibinj.pdf (Accessed 26 February 2026).

Celgene Limited Revlimid New Zealand Datasheet 1 November 2024. https://www.medsafe.govt.nz/profs/datasheet/r/revlimidcap.pdf (Accessed 26 Febrary 2026).

Regimen details sometimes vary slightly from the published literature after recommendation by expert committee consensus.

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.