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Home > PCN MM - lenalidomide [continuous dosing] post autologous stem cell transplant

PCN MM - lenalidomide [continuous dosing] post autologous stem cell transplant

Treatment Overview

Start at day 90 to 100 following autologous stem cell transplant.

Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

Cycle details

Cycle 1 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
lenalidomide 10 mg Once daily oral administration 1 to 28

Full details

Cycle 1 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
lenalidomide 10 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: 2

Medication Dose Route Max duration Details
lenalidomide 10 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 10 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 10 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 10 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 10 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 10 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
lenalidomide 10 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: 9

Medication Dose Route Max duration Details
lenalidomide 10 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 10 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 10 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 10 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 10 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 10 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
lenalidomide 10 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: 16

Medication Dose Route Max duration Details
lenalidomide 10 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 10 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 10 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 10 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 10 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 10 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
lenalidomide 10 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: 23

Medication Dose Route Max duration Details
lenalidomide 10 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: 24

Medication Dose Route Max duration Details
lenalidomide 10 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: 25

Medication Dose Route Max duration Details
lenalidomide 10 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: 26

Medication Dose Route Max duration Details
lenalidomide 10 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: 27

Medication Dose Route Max duration Details
lenalidomide 10 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: 28

Medication Dose Route Max duration Details
lenalidomide 10 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:

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 may be considered
Emetogenicity: Minimal to low
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis may be considered
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

Weber, D. M., C. Chen, R. Niesvizky, et al. 2007. "Lenalidomide plus dexamethasone for relapsed multiple myeloma in North America." N Engl J Med 357(21):2133-2142. , PMID: 18032763

Dimopoulos, M., A. Spencer, M. Attal, et al. 2007. "Lenalidomide plus dexamethasone for relapsed or refractory multiple myeloma." N Engl J Med 357(21):2123-2132. , PMID: 18032762

McCarthy, P. L., K. Owzar, C. C. Hofmeister, et al. 2012. "Lenalidomide after stem-cell transplantation for multiple myeloma." N Engl J Med 366(19):1770-1781. , PMID: 22571201

Attal, M., V. Lauwers-Cances, G. Marit, et al. 2012. "Lenalidomide maintenance after stem-cell transplantation for multiple myeloma." N Engl J Med 366(19):1782-1791. , PMID: 22571202

Holstein, S. A., S. H. Jung, P. G. Richardson, et al. 2017. "Updated analysis of CALGB (Alliance) 100104 assessing lenalidomide versus placebo maintenance after single autologous stem-cell transplantation for multiple myeloma: a randomised, double-blind, phase 3 trial." Lancet Haematol 4(9):e431-e442. , PMID: 28826616

Palumbo A, Cavallo F, Gay F, et al. 2014” Autologous transplantation and maintenance therapy in multiple myeloma “ N Engl J Med 371 (10) 895-905. , PMID: 25184862

McCarthy, P. L., S. A. Holstein, M. T. Petrucci, et al. 2017. "Lenalidomide Maintenance After Autologous Stem-Cell Transplantation in Newly Diagnosed Multiple Myeloma: A Meta-Analysis." J Clin Oncol 35(29):3279-3289. , PMID: 28742454

Jackson, G. H., F. E. Davies, C. Pawlyn, et al. 2019. "Lenalidomide maintenance versus observation for patients with newly diagnosed multiple myeloma (Myeloma XI): a multicentre, open-label, randomised, phase 3 trial." Lancet Oncol 20(1):57-73. , PMID: 30559051

Alonso, R., M. T. Cedena, S. Wong, et al. 2020. "Prolonged lenalidomide maintenance therapy improves the depth of response in multiple myeloma." Blood Adv 4(10):2163-2171. , PMID: 32433744

Celgene Limited Revlimid New Zealand Datasheet 27 January 2022 https://www.medsafe.govt.nz/profs/datasheet/r/revlimidcap.pdf (Accessed 31/3/2022).

* 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.