Treatment of hematologic neoplasms with new immunomodulatory drugs (IMiDs).
Thalidomide and its derivatives represent a new class of antineoplastic drugs (IMiDs), which has been especially effective in certain hematologic malignancies. These agents have anti-inflammatory, antiangiogenic, and immunomodulatory properties, and target tumor cells by direct cytotoxicity and indirectly by interfering with several components of the bone marrow microenvironment. Thalidomide analogs that retain antitumor activity equal to or greater than the parent compound, but with less toxicity, have been developed. This paper summarizes what is known about the mechanisms of action of these agents, and recent clinical results. The data suggest that thalidomide analogs will play a major role in the management of certain hematologic neoplasms in the near future.
Wiernik
Peter H
PH
Comprehensive Cancer Center, Montefiore Medical Center-North Division, Bronx, NY 10466, USA. pwiernik@montefiore.org
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001853:Bone Marrow / Q000187:drug effects; D002872:Chromosome Deletion; D002895:Chromosomes, Human, Pair 5; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019337:Hematologic Neoplasms / Q000188:drug therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000077269:Lenalidomide; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy / Q000601:surgery; D009190:Myelodysplastic Syndromes / Q000188:drug therapy / Q000235:genetics; D016879:Salvage Therapy; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use*; D054556:Venous Thromboembolism / Q000139:chemically induced / Q000517:prevention & control; D055815:Young Adult
D000970:Antineoplastic Agents; D007155:Immunologic Factors; D013792:Thalidomide; C467566:pomalidomide; D000077269:Lenalidomide