Biological Activity of Lenalidomide and Its Underlying Therapeutic Effects in Multiple Myeloma.pdfVIP

Hindawi Publishing Corporation Advances in Hematology Volume 2012, Article ID 842945, 11 pages doi:10.1155/2012/842945 Review Article Biological Activity of Lenalidomide and Its Underlying Therapeutic Effects in Multiple Myeloma Roberta Martiniani, Valentina Di Loreto, Chiara Di Sano, Alessandra Lombardo, and Anna Marina Liberati Department of Oncohematology, University of Perugia, Santa Maria Hospital, 05100 Terni, Italy Correspondence should be addressed to Anna Marina Liberati, marinal@unipg.it Received 16 February 2012; Revised 1 May 2012; Accepted 2 May 2012 Academic Editor: Agostino Cortelezzi Copyright © 2012 Roberta Martiniani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Lenalidomide is a synthetic compound derived by modifying the chemical structure of thalidomide. It belongs to the second generation of immunomodulatory drugs (IMiDs) and possesses pleiotropic properties. Even if lenalidomide has been shown to be active in the treatment of several hematologic malignancies, this review article is mostly focalized on its mode of action in multiple myeloma. The present paper is about the direct and indirect antitumor effects of lenalidomide on malignant plasmacells, bone marrow microenvironment, bone resorption and host’s immune response. The molecular mechanisms and targets of lenalidomide remain largely unknown, but recent evidence shows cereblon (CRBN) as a possible mediator of its therapeutical effects. 1. Introduction to other B-cell neoplasia. The favourable toxic profile of