Immunomodulator drugs work by blocking the growth signal for cancer cells and by stimulating the body’s immune system to attack the cancer cells. The most common immunomodulators used for myeloma are thalidomide, lenalidomide and pomalidomide.
Thalidomide is an old drug that has new uses. It was given to pregnant women in the 1950s as an anti-nausea drug but was banned because it caused severe birth defects. We now know that thalidomide has anti-cancer properties that can be effective for myeloma. Lenalidomide and pomalidomide are newer types of immunomodulators.
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Immunomodulators are most often given in combination with a steroid and a chemotherapy drug. They are taken as tablets, usually every day or for a certain number of days each month. As some immunomodulator drugs increase the risk of blood clots, some people also take a blood thinner.
Possible side effects of immunomodulators include drowsiness, constipation, nausea, diarrhoea, rashes, blood clots, low blood count and a weakened immune system. Thalidomide may cause pain, numbness, tingling and muscle weakness in the hands and feet. This is known as peripheral neuropathy, but it is not a typical side effect of lenalidomide or pomalidomide.
Females taking immunomodulators should not become pregnant as the fetus would develop serious abnormalities. Sperm is also affected.
Males should not conceive and should not donate sperm. If you want to have children, discuss this with your doctor before treatment starts.
Prof John Gibson, Haematologist, Institute of Haematology, Royal Prince Alfred Hospital and The University of Sydney, NSW; Dr Stephanie Anderson, Registrar, Institute of Haematology, Royal Prince Alfred Hospital, NSW; Tanya Carney, Consumer; Jacqui Keogh, NSW State Manager/Senior Myeloma Nurse NSW, Myeloma Australia; Dr Silvia Ling, Haematologist, Liverpool Hospital, NSW; Rachel McCann, Myeloma Support Nurse NSW, Myeloma Australia; John McMath, Consumer; Karen Robinson, 13 11 20 Consultant, Cancer Council NSW.
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