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.
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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
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Kasi, P.M., Nowakowski, G.S. (2018). IMiD: Immunomodulatory Drug Lenalidomide (CC-5013; Revlimid) in the Treatment of Lymphoma: Insights into Clinical Use and Molecular Mechanisms. In: Ferreri, A. (eds) Resistance of Targeted Therapies Excluding Antibodies for Lymphomas. Resistance to Targeted Anti-Cancer Therapeutics, vol 17. Springer, Cham. https://doi.org/10.1007/978-3-319-75184-9_4
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