Principles of prevention and management of adverse events of immunomodulatory drugs in the treatment of multiple myeloma

Over the past 15 years, significant progress has been made in understanding the biology and treatment of multiple myeloma (MM). This is due to the introduction of new therapies and new applications of known drugs associated with a better understanding of how to optimize treatment to patient and disease characteristics. Indeed, 15 new drugs have been approved over this time period. Immunomodulatory drugs (IMiDs) have been used in the treatment of MM for over 20 years. Initially, it was thalidomide, then analogues lenalidomide and pomalidomide; in the future, cereblon E3 ligase modulators CelMoDs, such as iberdomide and CC-480. Currently, IMiDs are mainly used as the backbone of multi-drug protocols, including in combination with monoclonal antibodies and proteasome inhibitors. Given the common utilization of IMiDs in the management of MM, it is relevant to review the safety profile of IMiDs and the management of adverse events (AEs).