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Lenalidomide in Multiple Myeloma—A Practice Guideline

Department of Medical Oncology and Hematology, Princess Margaret Hospital, Toronto, ON, Canada
Department of Oncology, Program in Evidence-Based Care, McMaster University, Hamilton, ON, Canada
Regional Cancer Centre, Windsor Regional Hospital, Windsor, ON, Canada
Northeast Cancer Centre, Health Sciences North, Sudbury, ON, Canada
General Hematology and Oncology, Saint Michael’s Hospital, Toronto, ON, Canada
Department of Medical Oncology and Hematology, Odette Cancer Centre at Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Author to whom correspondence should be addressed.
Curr. Oncol. 2013, 20(2), 136-149;
Submission received: 2 January 2013 / Revised: 5 February 2013 / Accepted: 7 March 2013 / Published: 1 April 2013


Background: Promising new drugs such as lenalidomide, an immunomodulatory agent, are available for the treatment of multiple myeloma. We describe the process of creating a provincial guideline for the use of lenalidomide, alone or in combination with other drugs, in relapsed, refractory, or newly diagnosed disease (including smoldering and symptomatic patients, and candidates and non-candidates for transplant) and in maintenance treatment (after transplant or non-transplant therapy); and for strategies to manage lenalidomide-related toxicities. Methods: Outcomes of interest included overall survival, event-free survival, progression-free survival, time to progression, time to next treatment, response rate, and incidence of serious toxicity. The MEDLINE, EMBASE, and Cochrane Library databases, as well as meeting abstracts and the Web sites of relevant organizations, were systematically searched for relevant literature. Results: Recommendations were developed using the evidence from published studies and the clinical expertise of the working group and of the Cancer Care Ontario Hematology Disease Site Group. Conclusions: Lenalidomide in combination with dexamethasone can be recommended for both previously untreated and treated patients with multiple myeloma. Guidelines for the management of cytopenias, venous thromboembolism, and second primary malignancies are discussed.
Keywords: lenalidomide; multiple myeloma; IMiD; practice guideline lenalidomide; multiple myeloma; IMiD; practice guideline

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MDPI and ACS Style

Chen, C.; Baldassarre, F.; Kanjeekal, S.; Herst, J.; Hicks, L.; Cheung, M. Lenalidomide in Multiple Myeloma—A Practice Guideline. Curr. Oncol. 2013, 20, 136-149.

AMA Style

Chen C, Baldassarre F, Kanjeekal S, Herst J, Hicks L, Cheung M. Lenalidomide in Multiple Myeloma—A Practice Guideline. Current Oncology. 2013; 20(2):136-149.

Chicago/Turabian Style

Chen, C., F. Baldassarre, S. Kanjeekal, J. Herst, L. Hicks, and M. Cheung. 2013. "Lenalidomide in Multiple Myeloma—A Practice Guideline" Current Oncology 20, no. 2: 136-149.

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