Holstein Sarah A, Suman Vera J, McCarthy Philip L
Division of Oncology and Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
Ther Adv Hematol. 2018 Jul;9(7):175-190. doi: 10.1177/2040620718775629. Epub 2018 May 26.
Lenalidomide is a derivative of thalidomide and belongs to the class of drugs known as the immunomodulatory drugs (IMiDs). The IMiDs have played a large role in improving the survival outcomes of patients with multiple myeloma. In particular, lenalidomide is currently standard of care in the newly diagnosed setting, in the maintenance setting post-autologous stem cell transplant, as well as in the relapsed/refractory setting. While the combination of lenalidomide and various proteasome inhibitors has proven particularly effective, there are emerging data demonstrating the effectiveness of lenalidomide in combination with other important classes of drugs including the monoclonal antibodies. Recent studies have provided insight into the molecular target of lenalidomide and the other IMiDs, although there is still much to be learned regarding the mechanisms by which lenalidomide affects the myeloma cell and the immune system. Here we review the molecular mechanisms of action, side effects, and the results of the clinical trials which have led to the widespread incorporation of lenalidomide into the myeloma therapeutic armamentarium.
来那度胺是沙利度胺的衍生物，属于免疫调节药物（IMiDs）类别。IMiDs在改善多发性骨髓瘤患者的生存结局方面发挥了重要作用。特别是，来那度胺目前是新诊断患者、自体干细胞移植后维持治疗以及复发/难治性患者的标准治疗药物。虽然来那度胺与各种蛋白酶体抑制剂的联合已被证明特别有效，但有新数据表明来那度胺与包括单克隆抗体在内的其他重要药物类别联合也有效。最近的研究深入了解了来那度胺和其他IMiDs的分子靶点，尽管关于来那度胺影响骨髓瘤细胞和免疫系统的机制仍有很多需要了解的地方。在此，我们综述来那度胺的分子作用机制、副作用以及临床试验结果，这些试验结果已导致来那度胺广泛纳入骨髓瘤治疗药物库。
