LENAKAST-5 Capsules LENAKAST-5 contains Lenalidomide, a thalidomide analogue with potent immunomodulatory, anti-angiogenic, and direct anti-neoplastic properties. Lenalidomide binds directly to cereblon (CRBN), a component of the cullin-RING E3 ubiquitin ligase complex. This binding induces the selective ubiquitination and degradation of essential Ikaros transcription factors (IKZF1 and IKZF3), leading to direct cytotoxicity in malignant plasma cells and B-cells. Additionally, it enhances T-cell and Natural Killer (NK) cell-mediated immunity while inhibiting anti-inflammatory cytokines (TNF-α, IL-6, IL-12) and pro-angiogenic factors (VEGF, bFGF). It is indicated for the treatment of multiple myeloma, myelodysplastic syndromes (MDS) associated with a deletion 5q cytogenetic abnormality, and relapsed or refractory mantle cell lymphoma (MCL).