Official websites use. Share sensitive information only on official, secure websites. Correspondence: ktlee khu. The mass spectrometer was operated in a positive ion mode with an electrospray ionization interface and multiple reaction monitoring modes. For total lenalidomide concentrations, between-run precision coefficients of variation and accuracy were 1. For unbound concentrations, inter-day precision and accuracy were 1. The proposed analytical method was successfully applied to measure total and unbound lenalidomide concentrations at various time points in multiple myeloma patients with renal impairment.
Lenalidomide is an oral immunomodulatory agent with antiangiogenic and antitumor properties [ 1 ]. It is primarily used for the treatment of hematologic cancers, including multiple myeloma MM [ 2 ]. Although lenalidomide was initially approved for use with dexamethasone in patients with MM who had received at least one prior therapy, its indication has been substantially expanded [ 1 ]. In addition, the most updated treatment guidelines suggest lenalidomide monotherapy or combination therapy as a maintenance therapy after an autologous hematopoietic stem cell transplant [ 3 ].
With these updated guideline recommendations, as well as newer clinical trial findings, use of lenalidomide is expected to increase, particularly with the increasing prevalence of MM due to population ageing [ 5 ].
One of the challenges associated with lenalidomide therapy is the substantial variability of lenalidomide in plasma concentrations, potentially leading to concentration-dependent hematologic toxicities such as neutropenia, thrombocytopenia, and anemia [ 1 , 6 , 7 ].
Considering that lenalidomide is primarily excreted by the kidneys, most of the pharmacokinetic variabilities of lenalidomide might be accounted for by renal function [ 8 , 9 ]. Systemic exposures of lenalidomide could be significantly increased in patients with renal impairment, one of the common complications of MM [ 10 ].
