Lenalidomide is one of a series of immuno-modulatory drugs (IMiDs) that have been tested in a variety of malignant and nonmalig-nant disorders. The history and application of this family of drugs dates back to the 1950s when thalidomide, a synthetic glutamic acid derivative, was initially developed as an anticon-vulsant for the treatment of epilepsy. The IMiDs exhibit a multitude of biologic effects on cytokine and cell-mediated responses that likely play a role in their now well-documented activity in many human diseases. Lenalidomide is a second generation IMiD compound, developed by chemical modification of the structural backbone of thalidomide to enhance immunomodulatory potency and minimize the dose-limiting neuro-toxic effects.
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