Lenalidomide in lymphomas and chronic lymphocytic leukemia

Lenalidomide , a thalidomide analog, is representative of a new class of antineoplastic drugs which has been especially effective in certain hematologic malignancies such as myeloma and myelodysplasia. Lenalidomide has anti-inflammatory, anti-angiogenic and immunomodulatory properties, and targets tumor cells by direct cytotoxicity and, indirectly by interfering with several components of the tumor microenvironment [1]. Lenalidomide retains antitumor activity equal to or greater than the parent compound, thalidomide, but with less toxicity [2].

This paper summarizes what is known about the mechanisms of action of lenalidomide, and recent clinical results in lymphoma and chronic lymphocytic leukemia. A literature review was accomplished by searching the PubMed database for papers in English. Publications from 2000 through November 2012 were analyzed. Search terms used were lenalidomide, lymphoma, chronic lymphocytic leukemia, and Hodgkin's lymphoma. A manual search of conference proceedings from the previous 5 years of the American Society of Clinical Oncology, American Society of Hematology, America Association of Cancer Research, and the European Hematology Association was also conducted. Relevant references in chosen papers were also considered.

The data suggest that lenalidomide will play a major role in the management of certain lymphoid neoplasms such as B-cell lymphoma, chronic lymphocytic leukemia and, perhaps, T-cell lymphoma.