title: Novel immunomodulatory compounds in multiple myeloma.
abstract: BACKGROUND
  The treatment options for patients with multiple myeloma (MM) remain limited. Immunomodulatory agents (IMiDs), such as thalidomide and lenalidomide, have changed the landscape in the treatment of patients with MM while newer IMiDs such as pomalidomide are showing promise in early clinical trials.
  
  
  METHODS
  This review focuses on the biologic rationales of IMiDs and the clinical results supporting their use in MM. It includes data on the new IMiD, pomalidomide and also explores the possible utility of combining IMiDs with other agents. A PubMed search and abstracts from oncology scientific meetings (ASCO and ASH) of articles related to IMiDs and MM was conducted.
  
  
  CONCLUSIONS
  IMiDs have shown clinical activity as single agents and in combination. Thalidomide was the first in class drug. Lenalidomide has a better toxicity profile than thalidomide. Pomalidomide may overcome resistance to lenalidomide indicating differences in their mechanisms of action and resistance. Molecular biomarkers may allow us to identify patients who will respond to IMiDs.
authors.affiliation: North Shore Medical Center, Internal Medicine, Boston, MA, USA.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Saini
authors.forename: Anuj
authors.initials: A
authors.lastname: Mahindra
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*; D000077269:Lenalidomide; D015394:Molecular Structure; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000276:immunology; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives / Q000737:chemistry / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D007155:Immunologic Factors; D013792:Thalidomide; C467566:pomalidomide; D000077269:Lenalidomide