Immunomodulatory Drugs (IMiDs) in Multiple Myeloma.

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Immunomodulatory Drugs (IMiDs) in Multiple Myeloma.

Curr Cancer Drug Targets. 2017 Feb 13;:

Authors: Raza S, Safyan RA, Suzanne L

Abstract
Multiple myeloma (MM) is a plasma cell neoplasm that is incurable with conventional therapy. However, the treatment of MM has dramatically changed since the emergence of immunomodulatory drugs and proteasome inhibitors. The improvements in survival are linked to a deeper understanding of the molecular mechanisms of the disease. Thalidomide, although highly active in MM, is associated with considerable toxicity, particularly in older patients. Immunomodulatory drugs (IMiDs) are structural and functional analogues of thalidomide that represent a promising new class of immunomodulators for treatment of a variety of inflammatory, autoimmune, and neoplastic diseases. Lenalidomide, a second generation IMiD, is more potent and has a better toxicity profile than thalidomide. It is commonly used in newly-diagnosed multiple myeloma, relapse refractory myeloma and as maintenance therapy after autologous stem cell transplantation (ASCT). Pomalidomide, a third generation IMiD, is 10 times more potent than lenalidomide and has already shown impressive results in patients who are heavily pre-treated and refractory to both lenalidomide and bortezomib. Here we provide a comprehensive review on IMiDs including molecular mechanisms, recent advances in therapeutic applications and management of toxicities in the treatment of MM.

PMID: 28201976 [PubMed - as supplied by publisher]

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