rituximab + dexamethasone + lenalidomide

The combination of rituximab, dexamethasone, and lenalidomide (often referred to as R2-dex or lenalidomide-dexamethasone-rituximab) is a chemotherapy-free regimen used primarily in the treatment of various B-cell lymphomas. This combination leverages the immunomodulatory effects of lenalidomide, the anti-inflammatory properties of dexamethasone, and the targeted anti-CD20 action of rituximab. It works through multiple mechanisms, including lenalidomide's broad pharmacologic effects leading to antineoplastic activity, rituximab's targeting of B-cells via anti-CD20, and dexamethasone's corticosteroid action. The combination has shown significant efficacy in rituximab-resistant indolent B-cell or mantle cell lymphomas, as salvage therapy in refractory or relapsed aggressive B-cell non-Hodgkin lymphoma, and as a frontline therapy in frail older patients with diffuse large B-cell lymphoma (DLBCL). Common adverse events include hematological toxicities, gastrointestinal effects, fatigue, rash, and increased risk of thromboembolism. Lenalidomide is available only through a restricted distribution program (Lenalidomide REMS) due to potential serious side effects.

Other names

R2-dexR-2-dexR 2-dexlenalidomide-dexamethasone-rituximab