[Thalidomide: mechanisms of action and new insights in hematology].
Purpose. - Thalidomide, a major teratogen drug, was rehabilitated mainly in malignant hemopathy. Current knowledge and key points. - Thalidomide-mechanisms of action are well known, multiple, they combine immunomodulatory, antiangiogenic properties, and the modulation of cytokines, particularly tumour necrosis factor-alpha. Multiple trials are ongoing, however, the main indication remain multiple myeloma with a response rate of 30% in relapsed patients. Future prospects and projects. - New structural analogues of the thalidomide which priviligiate some of the thalidomide-specific mechanisms of action, the selected cytokine inhibitory drugs (SelCIDS) and the immunomodulatory drugs (IMiDs) family are under evaluation. The IMiDs, which mechanism is based on stimulation of T lymphopoiesis rather than inhibition of tumour necrosis factor-alpha, are under clinical trials in multiple myeloma with interesting results.
Leleu
X
X
Service des maladies du sang, hôpital Claude-Huriez, CHRU, Lille, France.
Micol
J B
JB
Guieze
R
R
Berthon
C
C
Kuhnovsky
F
F
Terriou
L
L
Moreau
A S
AS
Yakoub-Agha
I
I
Bauters
F
F
Facon
T
T
D000686:Amyloidosis / Q000188:drug therapy; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016207:Cytokines / Q000037:antagonists & inhibitors; D005500:Follow-Up Studies; D005544:Forecasting; D006402:Hematologic Diseases / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology / Q000627:therapeutic use; D000077269:Lenalidomide; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy; D009101:Multiple Myeloma / Q000188:drug therapy*; D009190:Myelodysplastic Syndromes / Q000188:drug therapy; D055728:Primary Myelofibrosis / Q000188:drug therapy; D012008:Recurrence; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology* / Q000627:therapeutic use*; D013997:Time Factors; D008258:Waldenstrom Macroglobulinemia / Q000188:drug therapy
D020533:Angiogenesis Inhibitors; D016207:Cytokines; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide