{"entity":{"id":"lenalidomide","kind":"drug","name":"Lenalidomide","aka":[],"tldr":"Lenalidomide is a thalidomide descendant that glues the proteins IKZF1 and IKZF3 to cereblon so the cell destroys them, killing plasma cells and rousing T cells. It is the backbone of myeloma treatment and maintenance, also used in mantle cell and follicular lymphoma, and generic since 2022.","summary":"Approved 2006 (myeloma with dexamethasone), 2017 (post-transplant maintenance), plus MDS del(5q), mantle cell and follicular lymphoma (R2). Generic since 2022. Degrades IKZF1/IKZF3 via cereblon, killing plasma cells and co-stimulating T cells; the basis for CELMoDs and molecular-glue degraders generally.","status":"approved","asOf":"2026-09-07","wikipedia":"https://en.wikipedia.org/wiki/Lenalidomide","links":[{"label":"FDA label (DailyMed)","url":"https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Lenalidomide"}],"tags":[],"related":[],"cancers":["multiple-myeloma","dlbcl","myeloma-transplant-ineligible"],"sections":[],"technologies":["protac-degrader"],"targets":["ikzf1","ikzf3"],"drugs":[],"companies":["bms","natco"],"institutions":[],"pathways":[],"terms":[],"trials":["nct05438043","nct04712097","nct05429268","nct06149286","nct05623020","nct05827016","nct06508658","nct06191744","nct06911502","nct04224493","nct07095452","nct06679101","nct04680052","nct05317416","nct05552222","nct06045806","nct04404283","nct05100862","nct05888493","nct05409066","nct05371093","nct05222555","nct02343042","nct04663347","nct04133636","nct05583617","nct07189065","nct06577025","nct05950165","nct06087653","nct02180711","nct07150091","nct04782687","nct04246086","nct06892522","nct05283720","nct04669171","nct07018050","nct04270409","nct06084936","nct06082102"],"people":[],"bottlenecks":[],"keyPapers":["paper-augment-lenalidomide-rituximab-leonard-jco-2019","paper-ifm-2009-attal-nejm-2017"],"journals":[],"dependsOn":[],"notes":[],"brand":"Revlimid","modality":"Immunomodulatory drug (cereblon E3 ligase modulator)","mechanism":"Binds cereblon (CRBN) in the CRL4 E3 ligase, recruiting Ikaros and Aiolos for ubiquitination and degradation; downregulates IRF4/MYC; enhances IL-2 and T/NK activity.","approvals":[{"region":"US","year":2005,"indication":"Transfusion-dependent anaemia in low-risk MDS with del(5q)"},{"region":"US","year":2006,"indication":"Relapsed myeloma with dexamethasone"},{"region":"US","year":2015,"indication":"Newly diagnosed myeloma with dexamethasone"},{"region":"US","year":2017,"indication":"Maintenance after autologous transplant"}],"mechanismSteps":["Lenalidomide binds cereblon in the CRL4 ubiquitin ligase","The complex gains affinity for Ikaros and Aiolos","Both transcription factors are ubiquitinated and destroyed","IRF4 and MYC fall; myeloma cell dies","T and NK cells lose an inhibitory brake and activate"],"dosing":{"route":"Oral","schedule":"25 mg days 1-21 of 28 (induction); 10-15 mg continuous (maintenance); renal dose 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