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IMiD: Immunomodulatory Drug Lenalidomide (CC-5013; Revlimid) in the Treatment of Lymphoma: Insights into Clinical Use and Molecular Mechanisms

  • Pashtoon Murtaza Kasi
  • Grzegorsz S. Nowakowski
Chapter
Part of the Resistance to Targeted Anti-Cancer Therapeutics book series (RTACT, volume 17)

Abstract

Immune modulation has been a focus of increasing interest particularly for patients with lymphoma through the new class of ‘immunomodulatory drugs’ called IMiDs. Lenalidomide is an oral thalidomide analogue drug that belongs to the second generation of IMiDs. The proposed mechanisms of action of lenalidomide and the IMiD class of drugs go beyond just traditional cytotoxicity. With further descriptions comes more knowledge of predictive markers as well as molecular mechanisms of resistance. These still are evolving areas of research. Furthermore, mechanisms of resistance to IMiDs and ways to overcome may be different in different tumor types. The goal of this chapter is to focus on the early descriptions and usage of the drug, and to the more recent understandings of mechanisms of resistance. The main focus is on lymphoma, particularly diffuse large B-cell lymphoma. Knowledge and molecular insights gained pertaining to potential methods of overcoming these methods of resistance from other tumor types are also presented.

Keywords

Lenalidomide IMiD Lymphoma Immunomodulatory Revlimid DLBCL GCB Non-GCB Non-Hodgkin’s Lymphoma 

Abbreviations

ABC

Activated B-cell subtype

ADCC

Antibody-dependent cellular cytotoxicity

COO

Cell of Origin

CTCAE

Common terminology criteria for adverse events

CtDNA

Circulating tumor DNA

DLBCL

Diffuse Large B-Cell Lymphoma

GCB

Germinal center B-cell-like type

IMiD

Immunomodulatory Drug

mAbs

Monoclonal antibodies

NHL

Non-Hodgkin’s Lymphoma

Non-GCB

Non-germinal B-cell-like type

R2ICE

Combination chemoimmunotherapy regimen R-ICE with the addition of lenalidomide (Revlimid)

R-ICE

Combination chemoimmunotherapy regimen consisting of rituximab, ifosfamide, carboplatin and etoposide

Notes

Conflict of Interest

The authors declare no conflicts of interest.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Pashtoon Murtaza Kasi
    • 1
  • Grzegorsz S. Nowakowski
    • 2
  1. 1.Division of OncologyCollege of Medicine and Oncology, Mayo ClinicJacksonvilleUSA
  2. 2.Division of HematologyMayo ClinicRochesterUSA

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