Lenalidomide Capsules: A Multifaceted Marvel in Hematologic Treatment

1. What Are Lenalidomide Capsules?
Lenalidomide is an immunomodulatory imide drug (IMiD) and a derivative of thalidomide designed to improve efficacy and tolerability. It comes packaged as hard gelatin capsules in varying strengths—2.5 mg up to 25 mg—for oral use. Widely known by its brand name Lenalid, it is identified on the WHO’s Essential Medicines list due to its transformative implications in treating multiple myeloma, MDS, and specific lymphomas .
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2. Mechanism of Action: Understanding How It Works
Lenalidomide operates through a dual mechanism:
a) Molecular Degradation via Cereblon
It acts as a molecular glue, binding to the E3 ubiquitin ligase complex CRL4^CRBN and reprogramming it to ubiquitinate and degrade target proteins like IKZF1, IKZF3, and CK1α. In multiple myeloma, this degrades transcription factors essential for malignant plasma cells, while in MDS 5q , it targets CK1α, effectively killing abnormal clonal cells.
b) Immune & Microenvironment Modulation
Also, Lenalidomide enhances T-cell and NK-cell activity, boosts levels of IL 2 and IFN γ, and suppresses inflammatory cytokines—strengthening anti-tumor immunity. Additionally, it has anti-angiogenic effects—disrupting tumor blood supply—and directly induces apoptosis in malignant cells. It inhibits osteoclast activation and disrupts tumor-stromal interactions as seen in MDS and myeloma