Lenalidomide (Revlimid) is an immunomodulatory drug that is a more potent analog of thalidomide and is approved in multiple myeloma and transfusion-dependent myelodysplasia. It has clinical activity in a variety of other malignancies, including CLL.
Two initial studies examining either an intermittent 25-mg daily oral dose for 21 days or a 5-mg daily oral dose with dose escalation to a 10-mg daily oral dose as tolerated given as continuous therapy were pursued initially in patients with relapsed CLL. The higher-dose, intermittent schedule was active with an ORR of 47% and a 9% CR. Major side effects of this therapy were cytopenias, rash, and tumor flare, which in some cases can be life threatening.
99.9% Purity Raw Lenalidomide Pharmaceutical Intermediates CAS 191732-72-6
Synonyms: 3-(7-amino-3-oxo-1h-isoindol-2-yl)piperidine-2,6-dione; 1-Oxo-2-(2,6-dioxopiperidin-3-yl)-4-aminoisoindoline; 3-(4-Amino-1,3-dihydro-1-oxo-2H-isoindol-2-yl)-2,6-piperidinedione; CC-5013; Revlimi; Lenalidomide(other anti-cancers); 3-(4-amino-1-oxo-1,3-dihydro-2H-isoindol-2-yl)piperidine-2,6-dione
Lenalidomide (trade name Revlimid) is a derivative of thalidomide introduced in 2004.
Lenalidomide was initially intended as a treatment for multiple myeloma, for which thalidomide is an accepted therapeutic treatment. Lenalidomide has also shown efficacy in the class of hematological disorders known as myelodysplastic syndromes (MDS). Along with several other drugs developed in recent years, lenalidomide has significantly improved overall survival in myeloma (which formerly carried a poor prognosis), although toxicity remains an issue for users.
Multiple myeloma is a cancer of the blood, characterized by accumulation of a plasma cell clone in the bone marrow. Lenalidomide is one of the novel drug agents used to treat multiple myeloma. It is a more potent molecular analog of thalidomide, which inhibits tumor angiogenesis, tumor secreted cytokines and tumor proliferation through the induction of apoptosis.
Compared to placebo, lenalidomide is effective at inducing a complete or "very good partial" response as well as improving progression-free survival. Adverse events more common in people receiving lenalidomide for myeloma were neutropenia (a decrease in the white blood cell count), deep vein thrombosis, infections, and an increased risk of other hematological malignancies. The risk of second primary hematological malignancies does not outweigh the benefit of using lenalidomide in relapsed or refractory multiple myeloma. It may be more difficult to mobilize stem cells for autograft in people who have received lenalidomide.
With myelodysplastic syndromes, the best results of lenalidomide were obtained in patients with the Chromosome 5q deletion syndrome (5q- syndrome). The syndrome results from deletions in human chromosome 5 that remove three adjacent genes, granulocyte-macrophage colony-stimulating factor, Platelet-derived growth factor receptor B, and Colony stimulating factor 1 receptor.
Lenalidomide is undergoing clinical trial as a treatment for Hodgkin's lymphoma, as well as non-Hodgkin's lymphoma, chronic lymphocytic leukemia and solid tumor cancers, such as carcinoma of the pancreas. One Phase 3 clinical trial being conducted by Celgene in elderly patients with B-cell chronic lymphocytic leukemia was halted in July 2013 when a disproportionate number of cancer deaths were observed during treatment with lenalidomide versus patients treated with chlorambucil.
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