The efficacy and drug interactions of Indian NATCO version of Lenalidomide
Lenalidomide, as an immunomodulatory agent, exerts anti-tumor and immunomodulatory effects through multiple mechanisms, and its drug interactions require special attention to the impact on the CYP enzyme system. The following provides a detailed explanation from three aspects: mechanism of action, clinical efficacy, and drug interactions.
1. Mechanism of action
(1) Direct anti-tumor effect
By inhibiting tumor cell proliferation and inducing apoptosis, dose-dependent inhibition was observed on multiple myeloma cell lines.
(2) Immune regulatory function
Enhance the activity of T cells and NK cells, promote the secretion of cytokines such as IL-2 and IFN - γ, and improve the tumor microenvironment.
(3) Angiogenesis inhibition
Downregulate the expression of angiogenic factors such as VEGF and bFGF, and inhibit the formation of new blood vessels associated with myeloma.
2. Clinical efficacy
(1) Multiple myeloma
The combination of dexamethasone extended the median progression free survival to 14-20 months, with an overall response rate of 60-70%.
(2) Myelodysplastic syndrome
The improvement rate of transfusion independence in patients with 5q deficiency was 67%, and the median duration of efficacy was 2.2 years.
(3) Mantle cell lymphoma
The objective remission rate of second-line treatment is about 28%, and the median duration of remission is 16.6 months.
3. Drug interactions
(1) CYP1A2 inhibitors
Fluvoxamine can increase the AUC of lenalidomide by 40%, and adverse reactions such as bone marrow suppression need to be monitored.
(2) CYP3A4 inducer
Rifampicin can reduce drug exposure by 56% and should not be used in combination to avoid treatment failure.
(3) Anticoagulant drugs
The combination of warfarin requires an increase in INR monitoring frequency, which increases the risk of thrombosis by 3-4 times.
(4) Hormonal drugs
Dexamethasone can enhance immune regulatory effects, but caution should be taken against the risk of infection.
Disclaimer：《The efficacy and drug interactions of Indian NATCO version of Lenalidomide》Edited and sorted by Seagull Pharmacy's editors. Please contact us in time if there is any infringement. In addition, the suggestions for drug usage, dosage and disease mentioned in the article are only for medical staff's reference, and can not be used as any basis for medication！