Next generation immunomodulatory drugs (IMiDs)
Building on the success of IMiDs such as lenalidomide and pomalidomide that have been widely used for the treatment of myeloma over the last decade, next generation IMiDs are now being developed that work more efficiently and with greater affinity. Examples currently in UK clinical trials include CC-94280 (mezigdomide), CC-220 (iberdomide) and ANV-419.
Mezigdomide and iberdomide are both cereblon E3 ligase modulators (CELMoDs) that act to target cancer-driving proteins for degradation and also initiate an immune response. As with many drugs used to treat myeloma, early studies show increased response when used in combination regimens. Side effects of using CELMoDs noted so far include neutropenia, thrombocytopenia, infection and peripheral neuropathy.