ABSTRACT
The use of immunomodulators represented by thalidomide and its derivatives in the treatment of multiple myeloma (MM) has made a breakthrough. Cereblon has been identified as a direct target for immunomodulators and plays a significant role in antiproliferation, proapoptotic effects, antiangiogenic activities, enhancement of the activity of T cells and NK cells and intervention of cell surface adhesion molecules between myeloma cells and bone marrow stromal cells. In recent years, majority of the MM patients treated with immunomodulators develop drug resistance. Both upstream and downstream factor expression of cereblon and epigenetic modification may be related to immunomodulatory drugs resistance in MM. This review discusses the mechanism of immunomodulatory drug resistance in MM.