Pomalidomide shows promise in enhancing immune responses in myeloma

A new editorial was published in Oncoscience's Volume 12 on January 14, 2025, titled "Pomalidomide improved immune profiles in myeloma."

The editorial by researchers Hannah Seah, Vaishnavi Reddy Bade, Lakshmi Bhavani Potluri, Srikanth Talluri, and Rao H. Prabhala from Dana-Farber Cancer Institute, VA Boston Healthcare System, and Harvard Medical School, discuss how the drug pomalidomide (POM) can help improve the immune system in patients with hard-to-treat multiple myeloma, a type of blood cancer. The authors explain that adding pomalidomide to standard treatments may help strengthen the immune system and improve patient outcomes.

Multiple myeloma affects plasma cells in the bone marrow. It weakens the immune system, making patients more vulnerable to infections and other complications. While treatments have improved in recent years, the disease often returns, creating an urgent need for new strategies.

The editorial reviews different studies, including some conducted by the authors, showing that patients who received pomalidomide along with standard drugs like velcade, dexamethasone, or lenalidomide had stronger immune responses compared to those who did not receive the drug.

Clinical trials have shown that patients treated with pomalidomide experienced a longer period without disease progression-20.7 months compared to 11.6 months in patients who did not receive it. The editorial explains that pomalidomide works by enhancing key immune cells, such as T cells and natural killer (NK) cells, which helps the body recognize and destroy cancer cells.

At a molecular level, the drug helps break down proteins that suppress immune function, allowing the body to trigger a stronger response against cancer cells. The authors suggest that these effects could explain the clinical benefits seen in patients treated with pomalidomide-based regimens.

"POM targets Cereblon, which is part of the CRL4 E3 ubiquitin ligase, leading to the degradation of Ikaros and Aiolos, which are T cell repressors."

The authors emphasize that these immune-boosting effects could make pomalidomide a valuable option for patients whose myeloma has returned after previous treatments. By restoring immune cell function, pomalidomide may help slow disease progression and improve survival rates. 

In conclusion, the editorial underscores the potential of pomalidomide as a key player in the treatment of multiple myeloma. By enhancing the immune function and improving progression-free survival, the drug offers a new strategy for patients facing limited treatment options.