Are there specific indications where you would use thalidomide over lenalidomide for treatment of newly diagnosed multiple myeloma?

I would like to preface this response by noting that this is specific to a US practice setting. The short answer is that in the US, we rarely, if ever, use thalidomide in the frontline or relapsed setting in contemporary practice. This is due to the increased incidence of severe neuropathy with thalidomide use, and the availability of effective and better tolerated alternatives. Perhaps, the only setting where I have used thalidomide is as part of the VDT-PACE regimen in patients with plasma cel...