title: Prognostic indicators of lenalidomide for multiple myeloma: consensus and controversy.
abstract: The long-term outcome of multiple myeloma (MM) has been greatly improved through new agents, one being lenalidomide (LEN). Based upon the findings of in vitro experiments, its mode of action against MM occurs through a combination of direct tumoricidal effects on myeloma cells, modulatory effects on tumor immunity and tumor microenvironment-regulatory effects. However, it has not been clearly defined whether the clinical response and long-term outcome of MM with LEN treatment truly reflect the mechanisms of action of LEN proposed by in vitro studies. To ascertain what is known and what remains to be elucidated with LEN, we review the current literature on the mode of action of LEN in association with myeloma pathophysiology, and discuss the prognostic indicators in the treatment of MM with LEN.
authors.affiliation: Department of Medicine, Division of Hematology and Oncology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-Ku, Kyoto, 602-8566, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Kuroda
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Taniwaki
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D020732:Cytogenetic Analysis; D019008:Drug Resistance, Neoplasm; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D000077269:Lenalidomide; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000503:physiopathology; D011379:Prognosis; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000276:immunology / Q000627:therapeutic use; D059016:Tumor Microenvironment / Q000187:drug effects
chemical_list: D015415:Biomarkers; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: cereblon; cytogenetics; immunomodulatory drug; lenalidomide; mode of action; multiple myeloma; prognostic indicators; treatment history