Revlimid
Meaning of Revlimid: A chemical relative of thalidomide, redeveloped for cancer and now a mainstay of treatment for multiple myeloma.
Definition of Revlimid
Revlimid is the brand name for lenalidomide, an oral cancer medicine derived from thalidomide and classed as an immunomodulatory agent. It works inside the cell by redirecting a protein disposal system to destroy two control proteins that myeloma cells depend on, while also stirring immune cells to attack the tumor and limiting the new blood vessels it needs.
What is it used for?
| Condition | Where Revlimid fits |
|---|---|
| Multiple myeloma | Combined with other drugs at diagnosis and after relapse, and continued alone as maintenance once initial treatment is complete |
| Myelodysplastic syndrome with a particular deletion on chromosome 5 | For transfusion dependent anemia, where it can restore a workable blood count for a period |
| Mantle cell lymphoma and some slow growing lymphomas | Alone or alongside an antibody treatment after earlier therapy has stopped working |
Across all of these the common ground is a disease of the bone marrow or lymph glands rather than a solid tumor. It is taken as a capsule in cycles, with breaks built into the schedule, which is one reason it displaced treatments requiring a hospital visit for infusion.
How does it differ from thalidomide?
Both bind the same target inside the cell, a protein called cereblon that forms part of the machinery tagging unwanted proteins for destruction. Attaching to it changes what that machinery goes after, so proteins the cancer cell needs are broken down instead. Lenalidomide was designed to keep that useful activity while shedding some of the older drug's burdens, and it causes markedly less nerve damage and less sedation. What it did not shed is the effect on a developing fetus, and it suppresses blood counts more than its predecessor did.
What risks come with it?
The severe birth defects associated with the family remain the central concern, and supply is controlled through a program of pregnancy testing and documented counseling rather than ordinary prescribing. Neutrophil and platelet counts commonly fall, so blood is monitored throughout. The drug raises the risk of clots in the leg and lung enough that preventive treatment is standard alongside it, particularly when it is combined with a steroid. Rash, diarrhea and fatigue are frequent, and long maintenance carries a small increase in second cancers. Because it works partly by rousing the immune system, effects that resemble inflammation are expected rather than surprising.
Also known as
Used in a sentence
Revlimid was added to the treatment regimen for the patient's multiple myeloma.
Good to know
Revlimid's relation to thalidomide carries a serious risk of birth defects in pregnancy, which is why access to the medication is controlled through a monitored distribution program rather than ordinary prescribing.