Myeloma Nurse Learning Programme Module 7 – Drug development and new treatments in myeloma Drug discovery

Drug discovery

Drug discovery begins with the search for a “lead compound” that may act on the target to alter the disease course. If successful, the lead compound could eventually become a new drug.

There are a number of ways of identifying a lead compound including:

Nature – historically, many important drugs were originally derived from bacteria, mould or plants. Although nature still offers many useful molecules, this approach is no longer used to discover drugs
De novo – with advances in technology, molecules can be created using computer modelling to predict what type of molecule may work
High-throughput screening – currently, this is the most common way lead compounds are discovered, leveraging automation to test the biological or biochemical activity of hundreds of thousands of compounds against the target
Biotechnology – using genetic engineering of living systems to produce biological molecules
Modifying existing therapeutic drugs – structural changes made to improve the efficacy against the target. For example, in myeloma, thalidomide has a strong anti-myeloma effect but is hampered by a clinically challenging and potentially treatment-limiting side effect profile. Consequently, the thalidomide molecule was modified to produce derivatives (lenalidomide (Revlimid^®), pomalidomide (Imnovid^®)) with similar, if not better, efficacy and generally a more favourable side effect profile

Drug discovery

Further reading