Optimizing strategies lenalidomide therapy in the treatment of multiple myeloma

The introduction of new drugs (immunomodulators, proteasome inhibitors) into the treatment of multiple myeloma (MM) has contributed to the increase in response rates and also to a significant prolongation of overall survival, allowing multiple myeloma to become a chronic disease. Lenalidomide is an immunomodulatory agent, more effective and less toxic than the first immunomodulatory drug introduced into MM therapy - thalidomide. Lenalidomide should be given continously and longer treatment is associated with increased response rates and improved quality of response. That is why prophylaxis and proper management of adverse events is extremely important for continuation of the therapy. The dose of lenalidomide should be modified in patients with renal failure and cytopenias, also effective venous thromboembolism (VTE) is required. This article describes optimization of lenalidomide therapy with regard to the most common clinical problems