Mechanism in Multiple Myeloma
Thalidomide appears to inhibit the disease progression in multiple myeloma by several mechanisms, as resulting mainly from experiments on myeloma cancer cell lines:
- Inhibition of the production of interleukin-6 (IL‑6), which is a growth factor for the proliferation of myeloma cells
- Activation of apoptotic pathways through caspase 8-mediated cell death
- At the mitochondrial level, thalidomide results in induction of c-jun terminal kinase (JNK)-dependent release of cytochrome‑c and Smac into the cytosol of cells, affecting apoptosis.
- Activation of T cells to produce IL‑2, thereby altering the amount and function of natural killer cells (NK cells), thus augmenting the activity of NK‑dependent cytotoxicity
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