Novel treatment options in lymphoma and leukemia 2

Published on May 29, 2017   38 min
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So we'll now be moving on to another class of drugs called immunomodulatory agents and a few examples in these class of drugs are lenalidomide and pomalidomide. So these drugs have a unique class of action and several pathways have been recognized as being involved that are targeted by these novel group of agents. Several investigators have reported antiproliferative and pro-apoptotic effects of immunomodulatory agents on tumor cells in vitro. An important effect of the immunomodulatory agents is its ability to modulate production of various cytokines in the tumor microenvironment. Lenalidomide is reported to down regulate key pro-survival cytokines such as tumor necrosis factor, the TNF alpha and interleukin-6, interleukin-8, and Vascular Endocrinal Growth Factor or the VEGF. Cytokines that enrich the malignant microenvironment favoring tumor cell survival and proliferation and resistance to therapy as well. Lenalidomide may also affect other components of the tumor microenvironment including the immune cellular compartment. The preclinical observations demonstrate its activity of immune effector cells such as the T-cells and the NK cells, stimulating T-cell proliferation and increased production of IL-2 and interferon gamma through T-cell receptor activation. Also activation and proliferation of NK cells has been reported with lenalidomide. So there is no one specific mechanism of action of these agents and with its varied mechanism of actions, it is unclear as to if one particular pathway is more active, suggesting its better treatment in either lymphomas or multiple myeloma where it has received its approval for multiple myeloma. While lenalidomide is approved in combination with the steroids or other monoclonal antibodies in multiple myeloma, in lymphoma, it's currently under investigation, specifically in indolent lymphomas. Lenalidomide is approved, however, for mantle cell lymphoma and in the next few slides we will be discussing various studies involving lenalidomide.
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Novel treatment options in lymphoma and leukemia 2

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