Lenalidomide: Cancer therapy via antiangiogenesis and immunomodulation

Our rapidly expanding understanding of the molecular pathogenesis of a variety of cancers is providing new molecular targets for drug development; specifically, immunomodulatory and antiangiogenic agents are poised to become essential in novel cancer therapeutics. Rationale for the development of such therapies rest in the observation that these immune and angiogenic targets (e.g. TNF-α, VEGF, IL-6, IL-2 and IFN-γ) are at the core of cancer growth and progression, and are aberrant and deregulated in many human malignancies. Successful immunomodulation and inhibition of aberrant angiogenesis pathways are essential for malignant tumor cells. Herein we present an overview of immune modulation and angiogenesis in cancer. We will also review preclinical and clinical development, pharmacology and clinical trials of lenalidomide (Revlimid®, formerly CC-5013; Celgene Corporation), and agent that alters both pathways.