Is pomalidomide a chemotherapy drug or a targeted drug?

Pomalidomide (Pomalidomide) is not a chemotherapy drug in the traditional sense, nor is it a strictly defined molecular targeted therapy drug, but an immunomodulatory drug (IMiD). Its mechanism of action is between chemotherapy and targeted therapy, but it is more inclined to the targeted regulation category of modern molecular drugs. The development of pomalidomide originated from the optimization of the structures of Thalidomide and Lenalidomide. On the basis of inheriting the immunomodulatory functions of the former two, it has stronger anti-tumor activity and lower side effects. It is approved by the FDA for the treatment of multiple myeloma (MM) and Kaposi's sarcoma (KS), especially in relapsed and refractory patients who have failed to respond to lenalidomide and proteasome inhibitors.

Traditional chemotherapy drugs mostly kill cellsDNA or interfere with cell division, affecting cancer cells and normal cells, so they have strong side effects. Pomalidomide regulates the tumor microenvironment through multiple mechanisms, including inhibiting tumor angiogenesis, enhancing the activity of T cells and natural killer cells, inhibiting the release of pro-inflammatory cytokines, etc. It is a dual mechanism of immune system activation and tumor suppression. This precise adjustment method makes some of the characteristics of targeted therapeutic drugs, especially its mechanism of degrading specific oncogenic proteins after binding to CRBN protein (Cereblon), which is the basis of modern targeted protein degradation therapies (such as PROTAC) research.

Therefore, from a pharmacological perspective, although pomalidomide is not clearly defined as a "targeted drug", its mechanism is in line with the development direction of precision medicine, especially in the fields of immune regulation and protein degradation. It has shown obvious advantages. Unlike traditional chemotherapy, it is less toxic to normal cells, but side effects such as bone marrow suppression still need to be monitored during treatment.

Reference materials:https://en.wikipedia.org/wiki/Pomalidomide