Shahzad Raza, Rachael A. Safyan and Suzanne Lentzsch*Pages 846-857 (12)
Objective: 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.
Methods: Relevant publications in peer reviewed journals were retrieved by a selective search of PubMed. Systemic reviews, meta-analyses, randomized controlled trials, and treatment recommendations were reviewed and are summarized here.
Results: Thalidomide, a first generation IMiD, is associated with significant toxicity in older patients. Lenalidomide, a more potent second generation IMiD with fewer side effects than thalidomide, is commonly used in newly-diagnosed multiple myeloma, relapsed 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 shown impressive results in relapsed MM patients and in those refractory to both lenalidomide and bortezomib.
Conclusion: The clinical use of IMiDs in MM has significantly improved long-term survival and quality of life. Future studies are looking into novel biomarkers predictive of outcome in MM and new combinations of lenalidomide and pomalidomde with PI, monoclonal antibodies, immune checkpoint blockers and several other chemotherapies.
Immunomodulatory drugs, multiple myeloma, hematological cancer, IMiD, autologous stem cell transplantation.
Division of Hematology/Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, Division of Hematology/Oncology, College of Physicians and Surgeons, Columbia University, New York, NY, Department of Medicine, Division of Hematology/Oncology, College of Physicians and Surgeons, Columbia University, Herbert Irving Pavilion, R 953, 161 Ft. Washington Ave, New York, NY 10032