Immune Modulators and Myleoma. The small-molecule drugs thalidomide, lenalidomide, and pomalidomide bind to the protein cereblon (CRBN), which activates the enzymatic activity of the CRBN E3 ubiquitin ligase complex. The transcription factors Ikaros (IKZF1) and Aiolos (IKZF3) are modified with ubiquitin (Ub) molecules, targeting them for proteolysis. This alters the function of T cells and B cells, with a toxic outcome for multiple myeloma cells.From Stewart KA. How thalidomide works against cancer. Science. 2014;343:256-257. Reprinted with permission from AAAS.

Immune Modulators and Myleoma. The small-molecule drugs thalidomide, lenalidomide, and pomalidomide bind to the protein cereblon (CRBN), which activates the enzymatic activity of the CRBN E3 ubiquitin ligase complex. The transcription factors Ikaros (IKZF1) and Aiolos (IKZF3) are modified with ubiquitin (Ub) molecules, targeting them for proteolysis. This alters the function of T cells and B cells, with a toxic outcome for multiple myeloma cells.From Stewart KA. How thalidomide works against cancer. Science. 2014;343:256-257. Reprinted with permission from AAAS.

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