Lenalidomide inhibits the VEGF-induced PI3K-Akt pathway signaling and the HIF-1alfa expression [42], exerts an anti-TNF-alpha activity, modulates the immune response stimulating T cells and NK cells activities, induces apoptosis of tumor cells, and decreases the binding of MM cells to stromal cells [43]. This evidence concerns the gene VEGFA and Miyoshi myopathy.