AI Article Synopsis

  • Long-term treatment with lenalidomide and low-dose dexamethasone is crucial for effectively managing multiple myeloma (MM).
  • A study measured lenalidomide levels in patients 3 hours after taking the drug to identify why some patients discontinue therapy.
  • Findings revealed that patients who stopped treatment had lower lenalidomide concentrations and clearance rates, suggesting that monitoring drug levels could help maintain effective therapy and prevent discontinuation.

Article Abstract

Long-term combination treatment with lenalidomide and low-dose dexamethasone is important to achieve a curative effect in patients with multiple myeloma (MM). In this study, the plasma concentration of lenalidomide was measured at 3 h after oral administration, when the drug is in the elimination phase and can be easily measured in outpatients, to identify factors that may lead to the discontinuation of this combination therapy. Patients were assigned to continuation or discontinuation of therapy groups, and the baseline characteristics of patients, lenalidomide concentration, and concentration/dose (C/D) ratios reflecting oral clearance were compared between the two groups. The efficacy and severity of adverse events were also compared. The results showed that patients who discontinued or modified treatment had low plasma concentrations of lenalidomide and C/D ratios, indicating high oral clearance of lenalidomide. The estimated creatinine clearance rate was negatively correlated with the C/D ratio. The plasma concentrations of lenalidomide were independent from kidney function and differed significantly among patients. Taken together, the results indicate that low plasma concentrations of lenalidomide and low C/D ratios may lead to discontinuation of combination therapy in patients with MM. This suggests that early measurement of lenalidomide plasma continuation would help to prevent discontinuation of therapy or a delay in modifying the dose of lenalidomide.

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http://dx.doi.org/10.1248/bpb.b20-00337DOI Listing

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