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IMiD: Immunomodulatory Drug Lenalidomide (CC-5013; Revlimid) in the Treatment of Lymphoma: Insights into Clinical Use and Molecular Mechanisms

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Resistance of Targeted Therapies Excluding Antibodies for Lymphomas

Part of the book series: Resistance to Targeted Anti-Cancer Therapeutics ((RTACT,volume 17))

Abstract

Immune modulation has been a focus of increasing interest particularly for patients with lymphoma through the new class of ‘immunomodulatory drugs’ called IMiDs. Lenalidomide is an oral thalidomide analogue drug that belongs to the second generation of IMiDs. The proposed mechanisms of action of lenalidomide and the IMiD class of drugs go beyond just traditional cytotoxicity. With further descriptions comes more knowledge of predictive markers as well as molecular mechanisms of resistance. These still are evolving areas of research. Furthermore, mechanisms of resistance to IMiDs and ways to overcome may be different in different tumor types. The goal of this chapter is to focus on the early descriptions and usage of the drug, and to the more recent understandings of mechanisms of resistance. The main focus is on lymphoma, particularly diffuse large B-cell lymphoma. Knowledge and molecular insights gained pertaining to potential methods of overcoming these methods of resistance from other tumor types are also presented.

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Abbreviations

ABC:

Activated B-cell subtype

ADCC:

Antibody-dependent cellular cytotoxicity

COO:

Cell of Origin

CTCAE:

Common terminology criteria for adverse events

CtDNA:

Circulating tumor DNA

DLBCL:

Diffuse Large B-Cell Lymphoma

GCB:

Germinal center B-cell-like type

IMiD:

Immunomodulatory Drug

mAbs:

Monoclonal antibodies

NHL:

Non-Hodgkin’s Lymphoma

Non-GCB:

Non-germinal B-cell-like type

R2ICE:

Combination chemoimmunotherapy regimen R-ICE with the addition of lenalidomide (Revlimid)

R-ICE:

Combination chemoimmunotherapy regimen consisting of rituximab, ifosfamide, carboplatin and etoposide

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Conflict of Interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Division of Oncology, College of Medicine and Oncology, Mayo Clinic, Jacksonville, FL, USA

    Pashtoon Murtaza Kasi

  2. Division of Hematology, Mayo Clinic, Rochester, MN, USA

    Grzegorsz S. Nowakowski

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  1. Pashtoon Murtaza Kasi
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  2. Grzegorsz S. Nowakowski
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Correspondence to Pashtoon Murtaza Kasi .

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Editors and Affiliations

  1. Department of Onco-Hematology, Unit of Lymphoid Malignancies, IRCCS San Raffaele Scientific Institute, Milan, Italy

    Andrés J. M. Ferreri

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Kasi, P.M., Nowakowski, G.S. (2018). IMiD: Immunomodulatory Drug Lenalidomide (CC-5013; Revlimid) in the Treatment of Lymphoma: Insights into Clinical Use and Molecular Mechanisms. In: Ferreri, A. (eds) Resistance of Targeted Therapies Excluding Antibodies for Lymphomas. Resistance to Targeted Anti-Cancer Therapeutics, vol 17. Springer, Cham. https://doi.org/10.1007/978-3-319-75184-9_4

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