What's Old is New: The Past, Present and Future Role of Thalidomide in the Modern-Day Management of Multiple Myeloma.
Journal
Targeted oncology
ISSN: 1776-260X
Titre abrégé: Target Oncol
Pays: France
ID NLM: 101270595
Informations de publication
Date de publication:
07 2022
07 2022
Historique:
accepted:
06
06
2022
pubmed:
1
7
2022
medline:
5
8
2022
entrez:
30
6
2022
Statut:
ppublish
Résumé
Immunomodulatory drugs (IMiDs) have become an integral part of therapy for both newly diagnosed and relapsed/refractory multiple myeloma (RRMM). IMiDs bind to cereblon, leading to the degradation of proteins involved in B-cell survival and proliferation. Thalidomide, a first-generation IMiD, has little to no myelosuppressive potential, negligible renal clearance, and long-proven anti-myeloma activity. However, thalidomide's adverse effects (e.g., somnolence, constipation, and peripheral neuropathy) and the advent of more potent therapeutic options has led to the drug being less frequently used in many countries, including the US and Canada. Newer-generation IMiDs, such as lenalidomide and pomalidomide, are utilized far more frequently. In numerous previous trials, salvage therapy with thalidomide (50-200 mg/day) plus corticosteroids (with or without selected cytotoxic or targeted agents) has been shown to be effective and well-tolerated in the RRMM setting. Hence, thalidomide-based regimens remain important alternatives for heavily pretreated patients, especially for those who have no access to novel therapies and/or are not eligible for their use (due to renal failure, high-grade myelosuppression, or significant comorbidities). Ongoing and future trials may provide further insights into the current role of thalidomide, especially by comparing thalidomide-containing regimens with protocols based on newer-generation IMiDs and by investigating thalidomide's association with novel therapies (e.g., antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptor T cells).
Identifiants
pubmed: 35771402
doi: 10.1007/s11523-022-00897-8
pii: 10.1007/s11523-022-00897-8
doi:
Substances chimiques
Antineoplastic Agents
0
Immunologic Factors
0
Thalidomide
4Z8R6ORS6L
Lenalidomide
F0P408N6V4
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
383-405Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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