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Lenalidomide + cyclophosphamide is a combination regimen that was evaluated for the treatment of metastatic castration-resistant prostate cancer (mCRPC). Lenalidomide is a small molecule immunomodulatory drug (IMiD) and thalidomide analogue that binds to cereblon, a component of the E3 ubiquitin ligase complex, resulting in the degradation of target proteins and subsequent antiangiogenic and antineoplastic effects. Cyclophosphamide is a nitrogen mustard alkylating agent that cross-links DNA, inhibiting DNA synthesis and cell division. A Phase I/II trial conducted by the University of Nebraska investigated the safety and efficacy of this combination, specifically evaluating its impact on prostate-specific antigen (PSA) levels and its ability to modulate the tumor microenvironment in hormone-refractory patients.
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