Immunomodulatory Drugs in Acute Myeloid Leukemia Treatment

SIMPLE SUMMARY: Immunomodulatory drugs (IMiDs) are a class of molecules composed of thalidomide and its analogs. There is a growing interest in IMiDs on the treatment of acute myeloid leukemia (AML) patients. As AML has a worse prognosis, especially in elderly patients, novel drugs such as IMiDs, as monotherapy or combination with standard induction chemotherapy or hypomethylating agents, are urgently needed. The effect of IMiDs on AML immunosurveillance seems to be the clue to understanding their clinical application in this setting. We describe the several IMiDs currently available and also future directions. Clinical trials have to find the optimal dosing and schedule and combination agents to improve response rates with the use of IMiDs and, finally, survival in patients with AML. ABSTRACT: Immunomodulatory drugs (IMiDs) are analogs of thalidomide. They have immunomodulatory, antiangiogenic and proapoptotic properties and exert a role in regulating the tumor microenvironment. Recently IMiDs have been investigated for their pleiotropic properties and their therapeutic applications in both solid tumors (melanoma, prostate carcinoma and differentiated thyroid cancer) and hematological malignancies. Nowadays, they are applied in de novo and relapsed/refractory multiple myeloma, in myelodysplastic syndrome, in del5q syndrome with specific use of lenalidomide and B-cell lymphoma. Several studies have been conducted in the last few years to explore IMiDs possible use in acute myeloid leukemia treatment. Here we report the mechanisms of action of IMiDs in acute myeloid leukemia and their potential future therapeutic application in this disease.