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Lenalidomide + sunitinib is a combination of two small molecule drugs developed for the treatment of advanced or metastatic renal cell carcinoma. **Lenalidomide** is an immunomodulatory drug that alters cytokine production, modulates T-cell and NK-cell function, and acts as a molecular glue to redirect substrate specificity of the CRL4^CRBN^ E3 ubiquitin ligase, resulting in the proteasomal degradation of target proteins such as IKZF1, IKZF3, and CK1α[2][4]. **Sunitinib** is a multi-targeted receptor tyrosine kinase inhibitor that blocks the activity of VEGF receptors, PDGF receptors, KIT, FLT-3, CSF-1R, and RET, leading to inhibition of angiogenesis and tumor cell proliferation[6]. The combination was investigated in a phase I/II trial for metastatic renal cell carcinoma, but unacceptable toxicity at tolerance limits precluded further clinical development[1][5][3]. Both agents are administered orally.
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