Lenalidomide directly binds to cereblon (CRBN), the component of CRL4CRBN E3 ubiquitin ligase, inducing the ubiquitination and degradation of IKZF1 (Ikaros) and IKZF3 (Aiolos) in MM cells, leading to cytotoxicity and immunomodulatory effects [8,9]. Here, CRBN is linked to Miyoshi myopathy.