Fernández-Lázaro Diego, Fernández-Lázaro César Ignacio, Caballero García Alberto, Córdova Martínez Alfredo
Departamento de Biología Celular, Histología y Farmacología, Facultad de Fisioterapia, Universidad de Valladolid, Campus de Soria, España.
Departamento de Anatomía, Facultad de Fisioterapia, Universidad de Valladolid, Campus de Soria, España.
Rev Med Chil. 2018 Dec;146(12):1444-1451. doi: 10.4067/s0034-98872018001201444.
Thalidomide changed the treatment of patients with multiple myeloma, however, its effectiveness has been compromised due to its side effects. New strategies are needed to specifically target the challenges of multiple myeloma through innovative, more effective, and less toxic therapy. The new immunomodulatory (IMiDs) compounds are structural and functional analogs of thalidomide, which were designed to improve the immunomodulatory and anticancer properties and tolerability profiles. We review the development of second generation IMiDs, lenalidomide and pomalidomide, their immunomodulatory and tumoricidal effects, their mechanisms of action, as well as the influence of dexamethasone on their effect and pharmacological resistance. In conclusion, lenalidomide and pomalidomide demonstrate a powerful activity and they are highly effective and well-tolerated treatment options for patients with myeloma, used alone or in combination with dexamethasone.
沙利度胺改变了多发性骨髓瘤患者的治疗方式，然而，由于其副作用，其有效性受到了损害。需要新的策略来通过创新、更有效且毒性更小的疗法专门应对多发性骨髓瘤的挑战。新型免疫调节剂（IMiDs）化合物是沙利度胺的结构和功能类似物，其设计目的是改善免疫调节和抗癌特性以及耐受性。我们综述了第二代IMiDs（来那度胺和泊马度胺）的研发、它们的免疫调节和杀肿瘤作用、作用机制，以及地塞米松对其效果和耐药性的影响。总之，来那度胺和泊马度胺显示出强大的活性，它们是用于骨髓瘤患者的单独使用或与地塞米松联合使用的高效且耐受性良好的治疗选择。
