Lenalidomide

Next week, the American Society of Clinical Oncology will hold its annual meeting. I expect a flood of press releases soon, as researchers tout their breakthroughs. I always look forward to that kind of thing.

I've already seen a couple, and both are related to the drug Lenalidomide, also known as Revlimid. Lenalidomide has been an approved treatment for Multiple Myeloma (another blood cancer) for a few years, and is now being tested for its effectiveness in other cancers, including Follicular NHL. Lenalidomide is another one of those treatments that works well, but nobody is really exactly sure why. But it seems to kill some cancer cells directly, disrupt others' environments so they have trouble growing, and also serve as a immunomodulator (which means it messes with the immune system, which, in the case of blood cancers, is usually the problem).

The first study coming out of ASCO related to lenalidomide is called "Complete response rates with lenalidomide plus rituximab for untreated indolent B-cell non-Hodgkin's lymphoma." The researchers combined Revlimid (lenalidomide) with Rituxin. (This is another one of those combos that attack cancer cells from several different angles). This is a phase II clinical trial, so the numbers were limited: 30 patients. But 24 of them had a complete response, 2 had a partial response, and 4 had stable disease. 17 of the 30 had Follicular NHL and 16 of those achieved a complete response. Not bad. It will move to a pahse III trial now, with larger numbers of patients.

The other research report looks at how lenalidomide affects patients with transformed lymphoma -- one that has changed from a slow-growing, indolent type like Follicular to a more aggressive type. The article is called "Study Identifies Promising Treatment for Agressive Lymphoma," and it describes the "remarkable" (as they say) results for transformed patients. This is important for Follicular patients, since about 30% of us will transform. Right now, R-CHOP is the standard first attempt at treatment; after that, stem cell transplants are usually the next step, and then some other possibilities if that doesn't work. Lenalidomide would provide another option.

There seem to be relatively few side effects for lenalidomide, at least compared to some other treatments. Still no walk in the park -- anything that messes with the immune system is something to be dealt with carefully. But it seems to hold some real promise.

More from ASCO soon, I'm sure....