High expression of cereblon (CRBN) is associated with improved clinical response in patients with multiple myeloma treated with lenalidomide and dexamethasone

D Heintel, A Rocci, H Ludwig… - British journal of …, 2013 - Wiley Online Library
D Heintel, A Rocci, H Ludwig, A Bolomsky, S Caltagirone, M Schreder, S Pfeifer…
British journal of haematology, 2013Wiley Online Library
Cereblon (CRBN) has recently been identified as a target for immunomodulatory drugs (IM i
D s) and its downregulation has been linked to resistance to lenalidomide. Here, we studied
CRBN expression by real time polymerase chain reaction in 49 bone marrow samples of
newly diagnosed patients with multiple myeloma treated with lenalidomide and
dexamethasone. Median CRBN expression was 3· 45 in patients who achieved complete
response, and 3· 75, 2· 01, 0· 78, and 0· 70 in those with very good partial response, partial …
Summary
Cereblon (CRBN) has recently been identified as a target for immunomodulatory drugs (IMiDs) and its downregulation has been linked to resistance to lenalidomide. Here, we studied CRBN expression by real time polymerase chain reaction in 49 bone marrow samples of newly diagnosed patients with multiple myeloma treated with lenalidomide and dexamethasone. Median CRBN expression was 3·45 in patients who achieved complete response, and 3·75, 2·01, 0·78, and 0·70 in those with very good partial response, partial response, stable disease and progressive disease respectively. CRBN expression levels correlated significantly with response to lenalidomide treatment (r = 0·48; P < 0·001). Among established prognostic parameters, only beta‐2‐microglobulin correlated with cereblon (r = 0·66; P < 0·001). A close association of CRBN with interferon regulatory factor 4 (IRF4) (P < 0·001) and with CTNNB1 (P < 0·001) was found. Overall, a statistically significant association between baseline CRBN expression and response in MM patients treated with lenalidomide is shown. CRBN expression is closely associated with IRF4, which is an important target of IMiD therapy.
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