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13.07.2019 | B-cell NHL, T-cell NHL, and Hodgkin Lymphoma (J Amengual, Section Editor) | Ausgabe 5/2019

Current Hematologic Malignancy Reports 5/2019

IMiDs New and Old

Zeitschrift:
Current Hematologic Malignancy Reports > Ausgabe 5/2019
Autoren:
Samuel Yamshon, Jia Ruan
Wichtige Hinweise
This article is part of the Topical Collection on B-cell NHL, T-cell NHL, and Hodgkin Lymphoma

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Abstract

Purpose of Review

IMiDs are a class of biologic agents with immunomodulatory, anti-angiogenic, and direct anti-cancer activities. This review summarizes current data on clinical development and application of IMiDs in non-Hodgkin lymphoma (NHL) subtypes, focusing primarily on lenalidomide, with additional discussion on managing common side effects.

Recent Findings

Improved upon the prototype thalidomide, the second-generation compound lenalidomide has enhanced immunological and anti-cancer properties with fewer side effects, while next-generation small molecule cereblon/E3 ubiquitin ligase modulator CC-122 is in early clinical studies. Lenalidomide is FDA-approved for treatment of relapsed/refractory mantle cell lymphoma as a single agent, as well as in combination with rituximab for R/R follicular lymphoma and marginal zone lymphoma. In addition, numerous clinical trials of lenalidomide, as single agent, in combination with anti-CD20 antibodies, or in combination with chemoimmunotherapy regimens, have shown promise in aggressive and indolent NHL in both the upfront and relapsed/refractory setting.

Summary

As clinical trials with lenalidomide continue to find success in both indolent and aggressive lymphomas, IMiDs are poised to be important building blocks for combinatorial strategies with antibodies, chemotherapy, novel target agents, and emerging immunotherapy involving immune checkpoint inhibitors and chimeric antigen receptor T cell (CAR-T) therapy. Delineation of treatment-specific and disease-specific biomarkers is an important research objective to gain insight into potential mechanisms of action, and to guide future clinical development.

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