# Lenalidomide

Source: https://onco.cc/drugs/lenalidomide/  
OnCo record `lenalidomide` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Lenalidomide is a thalidomide descendant that glues the proteins IKZF1 and IKZF3 to cereblon so the cell destroys them, killing plasma cells and rousing T cells. It is the backbone of myeloma treatment and maintenance, also used in mantle cell and follicular lymphoma, and generic since 2022.

## Summary

Approved 2006 (myeloma with dexamethasone), 2017 (post-transplant maintenance), plus MDS del(5q), mantle cell and follicular lymphoma (R2). Generic since 2022. Degrades IKZF1/IKZF3 via cereblon, killing plasma cells and co-stimulating T cells; the basis for CELMoDs and molecular-glue degraders generally.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Revlimid
- Modality: Immunomodulatory drug (cereblon E3 ligase modulator)
- Mechanism: Binds cereblon (CRBN) in the CRL4 E3 ligase, recruiting Ikaros and Aiolos for ubiquitination and degradation; downregulates IRF4/MYC; enhances IL-2 and T/NK activity.
- Approvals: US 2005: Transfusion-dependent anaemia in low-risk MDS with del(5q); US 2006: Relapsed myeloma with dexamethasone; US 2015: Newly diagnosed myeloma with dexamethasone; US 2017: Maintenance after autologous transplant
- Dosing: Oral; 25 mg days 1-21 of 28 (induction); 10-15 mg continuous (maintenance); renal dose adjustment
- Toxicity (grade 3+): Neutropenia 35%

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Lenalidomide
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Lenalidomide

## Connected records

- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma)](https://onco.cc/cancers/malt-lymphoma/), [Follicular lymphoma](https://onco.cc/cancers/follicular-lymphoma/), [Lower-risk myelodysplastic syndromes](https://onco.cc/cancers/mds-lower-risk/), [Mantle cell lymphoma](https://onco.cc/cancers/mantle-cell-lymphoma/), [Marginal zone lymphoma](https://onco.cc/cancers/marginal-zone-lymphoma/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Myelodysplastic syndromes / neoplasms (MDS)](https://onco.cc/cancers/mds/), [Newly diagnosed multiple myeloma, transplant-eligible](https://onco.cc/cancers/myeloma-transplant-eligible/), [Newly diagnosed multiple myeloma, transplant-ineligible](https://onco.cc/cancers/myeloma-transplant-ineligible/), [Nodal marginal zone lymphoma](https://onco.cc/cancers/nodal-marginal-zone-lymphoma/), [Plasma cell leukaemia](https://onco.cc/cancers/plasma-cell-leukaemia/), [Plasmablastic lymphoma](https://onco.cc/cancers/plasmablastic-lymphoma/), [Primary CNS lymphoma](https://onco.cc/cancers/primary-cns-lymphoma/), [Smouldering multiple myeloma](https://onco.cc/cancers/smouldering-myeloma/), [Splenic marginal zone lymphoma](https://onco.cc/cancers/splenic-marginal-zone-lymphoma/)
- technologies: [PROTACs & molecular glues (targeted protein degradation)](https://onco.cc/technologies/protac-degrader/)
- targets: [Cereblon (CRBN)](https://onco.cc/targets/cereblon/), [IKZF1 (Ikaros)](https://onco.cc/targets/ikzf1/), [IKZF3 (Aiolos)](https://onco.cc/targets/ikzf3/), [IRF4](https://onco.cc/targets/irf4/)
- companies: [Bristol Myers Squibb](https://onco.cc/companies/bms/), [Lupeng Pharmaceuticals](https://onco.cc/companies/lupeng-pharmaceuticals/), [Natco Pharma](https://onco.cc/companies/natco/)
- trials: [A Novel Vaccine (EO2463) as Monotherapy and in Combination, for Treatment of Patients With Indolent Non-Hodgkin Lymphoma](https://onco.cc/trials/nct04669171/), [A Phase 3 Study to Assess Efficacy and Safety of Tafasitamab Plus Lenalidomide and Rituximab Compared to Placebo Plus Lenalidomide and Rituximab in Pa](https://onco.cc/trials/nct04680052/), [A Phase III Trial Comparing Tisagenlecleucel to Standard of Care (SoC) in Adult Participants With r/r Follicular Lymphoma](https://onco.cc/trials/nct05888493/), [A Study Evaluating the Efficacy and Safety of Mosunetuzumab in Combination With Lenalidomide in Comparison to Rituximab in Combination With Lenalidomi](https://onco.cc/trials/nct04712097/), [A Study Evaluating the Safety and Efficacy of Multiple Treatments in Participants With Multiple Myeloma](https://onco.cc/trials/nct05583617/), [A Study Evaluating the Safety, Pharmacokinetics, and Efficacy of Mosunetuzumab + Lenalidomide (+Len), and the Safety, Tolerability, and Pharmacokineti](https://onco.cc/trials/nct04246086/), [A Study of Belantamab Mafodotin Administered in Combination With Lenalidomide and Dexamethasone (BRd) Versus Daratumumab, Lenalidomide, and Dexamethas](https://onco.cc/trials/nct06679101/), [A Study of Daratumumab](https://onco.cc/trials/nct05438043/), [A Study of Different Sequences of Cilta-cel, Talquetamab in Combination With Daratumumab and Teclistamab in Combination With Daratumumab Following Ind](https://onco.cc/trials/nct06577025/), [A Study of JNJ-68284528, a Chimeric Antigen Receptor T Cell (CAR-T) Therapy Directed Against B-cell Maturation Antigen (BCMA) in Participants With Mul](https://onco.cc/trials/nct04133636/), [A Study of Rocbrutinib in Participants With Relapse or Refractory Non-GCB Diffuse Large B-Cell Lymphoma](https://onco.cc/trials/nct07189065/), [A Study of Subcutaneously Injected Epcoritamab Plus Oral Lenalidomide Tablets Compared to Intravenously (IV) Infused Rituximab Plus IV Infused Gemcita](https://onco.cc/trials/nct06508658/), [A Study of Teclistamab in Combination With Daratumumab and Lenalidomide (Tec-DR) and Talquetamab in Combination With Daratumumab and Lenalidomide (Tal](https://onco.cc/trials/nct05552222/), [A Study of Zanubrutinib Plus Anti-CD20 Versus Lenalidomide Plus Rituximab in Participants With Relapsed/Refractory Follicular or Marginal Zone Lymphom](https://onco.cc/trials/nct05100862/), [A Study to Assess A Change in Disease Activity and Adverse Events of Intravenous Etentamig and Daratumumab (Etentamig+D) Compared to Daratumumab, Lena](https://onco.cc/trials/nct07095452/), [A Study to Assess Change in Disease Activity and Adverse Events (AE)s in Adult Participants With Multiple Myeloma Receiving T Cell Engaging Bi/Tri-spe](https://onco.cc/trials/nct06892522/), [A Study to Assess Safety and Efficacy of CHO-H01 as a Single Agent/Combined With Lenalidomide in Subjects With Refractory or Relapsed Non-Hodgkin's Ly](https://onco.cc/trials/nct05950165/), [A Study to Assess the Efficacy, Safety, Pharmacodynamics, and Pharmacokinetics of Tazemetostat in Combination With Lenalidomide Plus Rituximab Versus ](https://onco.cc/trials/nct04224493/), [A Study to Compare Iberdomide Maintenance Versus Lenalidomide Maintenance Therapy Following Autologous Stem Cell Transplant in Participants With Newly](https://onco.cc/trials/nct05827016/), [A Study to Compare the Efficacy and Safety of Golcadomide in Combination With Rituximab (Golca + R) vs Investigator's Choice in Participants With Rela](https://onco.cc/trials/nct06911502/), [A Study to Compare the Efficacy and Safety of Idecabtagene Vicleucel With Lenalidomide Maintenance Therapy Versus Lenalidomide Maintenance Therapy Alo](https://onco.cc/trials/nct06045806/), [A Study to Evaluate Adverse Events and Change in Disease Activity of Subcutaneous (SC) Epcoritamab in Combination With Oral and Intravenous Anti-Neopl](https://onco.cc/trials/nct05283720/), [A Study to Evaluate Glofitamab as a Single Agent vs. Investigator's Choice in Participants With Relapsed/Refractory Mantle Cell Lymphoma](https://onco.cc/trials/nct06084936/), [A Study to Learn About the Effects of the Combination of Elranatamab, Daratumumab and Lenalidomide Compared With Daratumumab, Bortezomib, Lenalidomide](https://onco.cc/trials/nct05623020/), [A Trial to Find Out if Odronextamab Combined With Lenalidomide is Safe and Works Better Than Rituximab Combined With Lenalidomide in Adult Participant](https://onco.cc/trials/nct06149286/), [AUGMENT](https://onco.cc/trials/augment/), [Brentuximab Vedotin Plus Lenalidomide and Rituximab for the Treatment of Relapsed/Refractory DLBCL](https://onco.cc/trials/nct04404283/), [CARTITUDE-6](https://onco.cc/trials/cartitude-6/), [CEPHEUS](https://onco.cc/trials/cepheus/), [DETERMINATION](https://onco.cc/trials/determination/), [DRAMMATIC](https://onco.cc/trials/drammatic/), [Efficacy and Safety of Orelabrutinib Combined With Rituximab Versus Lenalidomide Combined With Rituximab in Patients With Relapsed/Refractory Marginal Zone Lymphoma](https://onco.cc/trials/nct06082102/), [frontMIND](https://onco.cc/trials/frontmind/), [IFM 2009](https://onco.cc/trials/ifm-2009/), [IMROZ](https://onco.cc/trials/imroz/), [Isatuximab in Combination With Lenalidomide and Dexamethasone in High-risk Smoldering Multiple Myeloma](https://onco.cc/trials/nct04270409/), [L-MIND](https://onco.cc/trials/l-mind/), [MAIA](https://onco.cc/trials/maia/), [MIL62 Plus Lenalidomide for Patients With Relapsed/Refractory Indolent Non-Hodgkin's Lymphoma (FL and MZL)](https://onco.cc/trials/nct04110301/), [Mosunetuzumab with lenalidomide in relapsed marginal zone lymphoma](https://onco.cc/trials/mosun-len-mzl/), [PERSEUS](https://onco.cc/trials/perseus/), [Phase II Study of Lenalidomide and Eltrombopag in Patients With Symptomatic Anemia](https://onco.cc/trials/nct01772420/), [Phase II Study of QLS32015 Combination Therapy in the Treatment of Multiple Myeloma](https://onco.cc/trials/nct07018050/), [Platform Study of Belantamab Mafodotin as Monotherapy and in Combination With Anti-cancer Treatments in Participants With Relapsed/Refractory Multiple](https://onco.cc/trials/nct04126200/), [Prevention of Anthracycline-Induced Cardiac Dysfunction With Dexrazoxane in Patients With Diffuse Large-B Cell Lymphoma](https://onco.cc/trials/nct06220032/), [RELEVANCE](https://onco.cc/trials/relevance/), [REMARC](https://onco.cc/trials/remarc/), [Safety and Efficacy Trial of Epcoritamab Combinations in Subjects With B-cell Non-Hodgkin Lymphoma (B-NHL)](https://onco.cc/trials/nct04663347/), [Safety and Pharmacokinetics Study of a Modified Tafasitamab IV Dosing Regimen Combined With Lenalidomide in R-R DLBCL Patients](https://onco.cc/trials/nct05222555/), [Safety, Efficacy, and Pharmacokinetics of Continuous Subcutaneous Lenalidomide in Multiple Myeloma (MM)](https://onco.cc/trials/nct06087653/), [Selinexor and Backbone Treatments of Multiple Myeloma Patients](https://onco.cc/trials/nct02343042/), [Study of Acalabrutinib Alone or in Combination Therapy in Subjects With B-cell Non-Hodgkin Lymphoma](https://onco.cc/trials/nct02180711/), [Study of Axicabtagene Ciloleucel Versus Standard of Care Therapy in Participants With Relapsed/Refractory Follicular Lymphoma](https://onco.cc/trials/nct05371093/), [Study of AZD0120 in Newly Diagnosed Multiple Myeloma Ineligible for ASCT](https://onco.cc/trials/nct07764978/), [Study of Selinexor Plus DRd for Newly Diagnosed Multiple Myeloma](https://onco.cc/trials/nct04782687/), [Study of Subcutaneous Epcoritamab in Combination With Intravenous Rituximab and Oral Lenalidomide (R2) to Assess Adverse Events and Change in Disease ](https://onco.cc/trials/nct06191744/), [Study of Subcutaneous Epcoritamab in Combination With Intravenous Rituximab and Oral Lenalidomide (R2) to Assess Adverse Events and Change in Disease ](https://onco.cc/trials/nct05409066/), [Study to Evaluate the Safety and Efficacy of Tafasitamab Plus Lenalidomide in Participants With Relapsed or Refractory Diffuse Large B-Cell Lymphoma (](https://onco.cc/trials/nct05429268/), [Study With Elranatamab Versus Lenalidomide in Patients With Newly Diagnosed Multiple Myeloma After Transplant](https://onco.cc/trials/nct05317416/), [Sub-study of Belantamab Mafodotin (GSK2857916) in Combination With Nirogacestat, Lenalidomide, and Dexamethasone in Participants With RRMM](https://onco.cc/trials/nct07150091/), [To Assess the Safety and Tolerability of Tafasitamab Alone or in Combination With Other Drugs in Japanese Participants With Non-Hodgkins Lymphoma (NHL](https://onco.cc/trials/nct04661007/)
- key papers: [AUGMENT: lenalidomide plus rituximab versus rituximab alone in relapsed indolent lymphoma](https://onco.cc/key-papers/paper-augment-lenalidomide-rituximab-leonard-jco-2019/), [Brentuximab vedotin combination for relapsed diffuse large B-cell lymphoma](https://onco.cc/key-papers/paper-echelon-3-brentuximab-lenalidomide-rituximab-dlbcl-jco-2025/), [CEPHEUS: daratumumab quadruplet for newly diagnosed myeloma patients not having a transplant, with MRD-negativity as the main endpoint](https://onco.cc/key-papers/paper-cepheus-dara-vrd-natmed-2025/), [E3A06: lenalidomide versus observation in smouldering multiple myeloma](https://onco.cc/key-papers/paper-e3a06-lenalidomide-smouldering-lonial-jco-2020/), [IFM 2009: lenalidomide, bortezomib and dexamethasone with or without upfront transplantation for myeloma](https://onco.cc/key-papers/paper-ifm-2009-attal-nejm-2017/), [Lenalidomide maintenance compared with placebo in responding elderly patients with diffuse large B-cell lymphoma treated with first-line R-CHOP](https://onco.cc/key-papers/paper-remarc-lenalidomide-maintenance-dlbcl-jco-2017/), [MAIA: adding daratumumab to lenalidomide-dexamethasone for older patients with newly diagnosed myeloma who cannot have a transplant](https://onco.cc/key-papers/paper-maia-daratumumab-rd-nejm-2019/), [PERSEUS: daratumumab added to bortezomib-lenalidomide-dexamethasone around autologous transplant in newly diagnosed myeloma](https://onco.cc/key-papers/paper-perseus-dara-vrd-transplant-nejm-2024/), [RELEVANCE: rituximab plus lenalidomide in advanced untreated follicular lymphoma](https://onco.cc/key-papers/paper-relevance-rituximab-lenalidomide-follicular-lymphoma-morschhauser-nejm-2018/), [Tafasitamab, lenalidomide, and rituximab in relapsed or refractory follicular lymphoma (inMIND): a global, phase 3, randomised controlled trial](https://onco.cc/key-papers/paper-inmind-tafasitamab-lenalidomide-rituximab-follicular-lancet-2026/)
- drugs: [Iberdomide](https://onco.cc/drugs/iberdomide/), [Tafasitamab](https://onco.cc/drugs/tafasitamab/)
- terms: [Choices made at the time of treatment that change the second cancer risk](https://onco.cc/terms/rejuv-second-choices-made-at-treatment/), [del(5q) (5q- syndrome and lenalidomide response)](https://onco.cc/terms/del5q/), [FLIPI, FLIPI2 and POD24 (follicular lymphoma risk)](https://onco.cc/terms/flipi/), [Immunomodulatory drugs (IMiDs) and CELMoDs](https://onco.cc/terms/imid/), [IPSS-R and IPSS-M (myelodysplastic syndrome risk scores)](https://onco.cc/terms/ipss-m-ipss-r/), [Lymphoma treatments that did not work: the negative trials worth knowing](https://onco.cc/terms/lymphoma-tx-failed-and-negative/), [M-protein, immunofixation and serum free light chains](https://onco.cc/terms/m-protein-free-light-chains/), [Maintenance and consolidation in lymphoma: where it works and where it does not](https://onco.cc/terms/lymphoma-tx-maintenance/), [Maintenance therapy](https://onco.cc/terms/maintenance-therapy/), [Platinum drugs and PARP inhibitors: the newer leukaemia risk](https://onco.cc/terms/rejuv-second-platinum-and-parp-inhibitors/), [POD24: progression of follicular lymphoma within two years, and why it changes the plan](https://onco.cc/terms/lymphoma-tx-pod24/), [Smouldering myeloma / MGUS](https://onco.cc/terms/smoldering-myeloma/), [The lymphoma regimen alphabet: R-CHOP, pola-R-CHP, DA-EPOCH-R, ABVD, BEACOPP and the rest](https://onco.cc/terms/lymphoma-tx-regimen-alphabet/), [Venous thromboembolism (VTE)](https://onco.cc/terms/vte/), [VRd and Dara-VRd (myeloma induction regimens)](https://onco.cc/terms/vrd/), [What the NHS in England funds for lymphoma, appraisal by appraisal](https://onco.cc/terms/lymphoma-tx-uk-access/)
- pairings: [CD38 antibody added to PI-IMiD-dex (quadruplet induction)](https://onco.cc/pairings/cd38-plus-triplet/)
- ideas: [Fixed-duration, chemotherapy-free first-line treatment for the indolent lymphomas](https://onco.cc/ideas/lymphoma-ev-fixed-duration-chemotherapy-free-first-line/), [MRD-guided treatment-free intervals in myeloma](https://onco.cc/ideas/idea-mrd-guided-stop-myeloma/)
- roadmaps: [Lymphoma roadmap: from a jaw tumour in Uganda and the first human cancer virus to gene-expression subtypes, PET-adapted chemotherapy, CAR-T cells, bispecific antibodies and the genetics-directed trials now recruiting](https://onco.cc/roadmaps/lymphoma-roadmap/)
- pathways: [B-cell receptor / BTK signalling (to NF-κB)](https://onco.cc/pathways/bcr-signalling/), [Ubiquitin-proteasome system & protein homeostasis](https://onco.cc/pathways/ubiquitin-proteasome-system/)
- people: [A. Keith Stewart](https://onco.cc/people/keith-stewart/), [Benjamin L. Ebert](https://onco.cc/people/benjamin-ebert/), [Kenneth C. Anderson](https://onco.cc/people/kenneth-anderson/), [Paul G. Richardson](https://onco.cc/people/paul-richardson/)

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