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6 Elevated levels of ROS cause damage to DNA, proteins, and lipids.
7 Tumour cells produce high levels of ROS, which maintain pro-tumourigenic signalling and resistance to apoptosis. However, toxic levels of ROS production in cancers can also activate anti-tumourigenic signalling, resulting in oxidative stress-induced tumour cell death.
8 Therefore, therapies that can eliminate ROS or elevate ROS production are potential effective cancer therapies. There is an inherent vulnerability in MM cells that high rates of immunoglobulin synthesis resulting in the high level of ROS. This provides a therapeutic potential for MM.
9 Recently, studies revealed that lenalidomide triggers antitumour activities in MM primarily by targeting cereblon (CRBN) and inducing ROS-mediated oxidative stress. IKZF1 and IKZF3 are essential transcription factors in multiple myeloma.