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KMID : 0366220150500010007
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Korean Journal of Hematology
2015 Volume.50 No. 1 p.7 ~ p.18
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Use of lenalidomide in the management of relapsed or refractory multiple myeloma: expert recommendations in Korea
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Kim Hyo-Jung
Yoon Sung-Soo
Eom Hyeon-Seok
Kim Ki-Hyun
Kim Jin-Seok
Lee Je-Jung
Bang Soo-Mee
Min Chang-Ki
Park Joon-Seong
Lee Jae-Hoon
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Abstract
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Multiple myeloma (MM) is the third most common hematologic malignancy in Korea. Historically, the incidence of MM in Korea has been lower than that in Western pop-ulations, although there is growing evidence that the incidence of MM in Asian pop-ulations, including Korea, is increasing rapidly. Despite advances in the management of MM, patients will ultimately relapse or become refractory to their current treatment, and alternative therapeutic options are required in the relapsed/refractory setting. In Korea, although lenalidomide/dexamethasone is indicated for the treatment of relapsed or re-fractory MM (RRMM) in patients who have received at least one prior therapy, lenalido-mide is reimbursable specifically only in patients with RRMM who have failed bortezo-mib-based treatment. Based on evidence from pivotal multinational clinical trials as well as recent studies in Asia, including Korea, lenalidomide/dexamethasone is an effective treatment option for patients with RRMM, regardless of age or disease status. Adverse events associated with lenalidomide/dexamethasone, including hematologic toxicity, ve-nous thromboembolism, fatigue, rash, infection, and muscle cramps, are largely predict-able and preventable/manageable with appropriate patient monitoring and/or the use of standard supportive medication and dose adjustment/interruption. Lenalidomide/dex-amethasone provides an optimal response when used at first relapse, and treatment should be continued long term until disease progression. With appropriate modification of the lenalidomide starting dose, lenalidomide/dexamethasone is effective in patients with renal impairment and/or cytopenia. This review presents updated evidence from the published clinical literature and provides recommendations from an expert panel of Korean physicians regarding the use of lenalidomide/dexamethasone in patients with RRMM.
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KEYWORD
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Guideline, Korea, Lenalidomide, Multiple myeloma, Refractory, Relapsed
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