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Lenalidomide in solid tumors

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Abstract

Background

Lenalidomide is a thalidomide analogue with immunomodulatory and anti-angiogenic properties that include altering cytokine production, activating T cells, and augmenting natural killer cell function. Lenalidomide is approved by the U.S. Food and Drug Administration (FDA) for single-agent treatment of myelodysplastic syndromes associated with a 5q deletion and as a combination therapy with dexamethasone for the treatment of multiple myeloma.

Methods

All prospective phase I–III clinical trials and preclinical data published until October 2011 and relevant literature were reviewed.

Results

In phase I and/or II studies of single-agent lenalidomide in patients with advanced cancer, responses were reported in patients with prostate, thyroid, hepatocellular, pancreatic, and renal cancer and melanoma. The most common toxicities were hematologic, and in the first clinical trials, thrombotic events were noted. When anticoagulation prophylaxis and exclusion of patients with a history of thrombosis were implemented, thrombotic complications became uncommon.

Conclusion

Monitoring of blood counts and for evidence of thromboembolic events is essential for patients treated with lenalidomide. Ongoing trials of lenalidomide combination therapy offer a treatment option for patients with advanced cancer and will better define the role of lenalidomide in solid tumors.

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Abbreviations

AEs:

Adverse events

AIPC:

Androgen independent prostate cancer

ASA:

Aspirin

BRPC:

Biochemically relapsed prostate cancer

CNS:

Central nervous system

CR:

Complete response

NE:

Not evaluable

ORR:

Overall response rate

OS:

Overall survival

PD:

Disease progression

PFS:

Progression-free survival

PR:

Partial response

PSA:

Prostate-specific antigen

RECIST:

Response evaluation criteria in solid tumors

SD:

Stable disease

TTP:

Time to progression

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Conflict of interest

Dr. Tsimberidou received research funding from Celgene.

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  1. Department of Investigational Cancer Therapeutics, Phase I Clinical Trials Program, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 455, Houston, TX, 77030, USA

    Angela Segler & Apostolia-Maria Tsimberidou

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Correspondence to Apostolia-Maria Tsimberidou.

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Segler, A., Tsimberidou, AM. Lenalidomide in solid tumors. Cancer Chemother Pharmacol 69, 1393–1406 (2012). https://doi.org/10.1007/s00280-012-1874-2

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