lenalidomide (Revlimid)

following a second re-submission:

lenalidomide (Revlimid®) is accepted for restricted use  within NHS Scotland.

Indication under review: in combination with dexamethasone, for the treatment of multiple myeloma in adult patients who have received at least one prior therapy. (This resubmission relates to patients who have received only one prior therapy).

SMC restriction: to use at first relapse in patients who have received prior therapy with bortezomib in whom thalidomide has not been tolerated or is contraindicated.

Lenalidomide plus dexamethasone significantly increased the time to progression compared with dexamethasone alone in multiple myeloma patients who had been treated with at least one prior therapy.

SMC has previously accepted lenalidomide for use in patients who have received at least two prior lines of therapy i.e. at second relapse.  This advice now extends its use to patients at first relapse who received bortezomib as their one prior therapy.