Patients will be excluded if any of the following are present:\r\n* Evidence of active bleeding, intratumoral hemorrhage, or bleeding diathesis\r\n* History (within months prior to study enrollment) of pulmonary embolism, deep vein thrombosis (DVT), or other venous thromboembolic event\r\n* History of hemoptysis within weeks prior to study enrollment History of pulmonary embolism within months prior to the first dose of ALRN- or untreated DVT (deep vein thrombosis) Participants with history of pulmonary embolism, deep vein thrombosis (DVT), or vascular access related thrombosis will be allowed on study provided they are receiving adequate anticoagulation at a stable dose at the time of study entry History of deep vein thrombosis (DVT) or pulmonary embolism (PE) in the past months Active thrombosis, or a history of deep vein thrombosis (DVT) or pulmonary embolism (PE) within weeks prior to Cycle /Day (C/D) unless adequately treated and considered stable Deep vein thrombosis (DVT) / pulmonary embolism (PE) in the past months prior to randomization Thromboembolic events and/or bleeding disorders ? days (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) prior to the first dose of study drug Patients unwilling to take deep vein thrombosis (DVT) prophylaxis. Active thrombosis, or a history of deep vein thrombosis (DVT) or pulmonary embolism (PE) within weeks prior to Cycle /Day (C/D) unless adequately treated and considered stable History or presence within the last months of Deep Vein Thrombosis (DVT) or a pulmonary embolism (PE);- Uncontrolled leptomeningeal disease; Subject has active or history of deep vein thrombosis (DVT) Thromboembolic event (e.g., deep vein thrombosis [DVT] and pulmonary embolism [PE]) ? weeks of CD. History of arterial thrombosis; patients with history of deep vein thrombosis (DVT) are eligible as long as they have received or are receiving appropriate anticoagulation therapy Concurrent medical problems that preclude use of deep vein thrombosis (DVT) prophylaxis with lenalidomide treatment History or presence of serious hemorrhage , hemoptysis or hematemesis within months or a thromboembolic event (including Deep Vein Thrombosis (DVT), stroke and/or transient ischemic attack) within months; Patients with squamous Non Small Cell Lung Cancer (NSCLC) should be excluded. Subjects with a history of deep vein thrombosis (DVT) or pulmonary embolism (PE) within months of study treatment initiation History of deep venous thrombosis (DVT) or pulmonary embolism (PE) Active thrombosis, or a history of deep vein thrombosis (DVT) or pulmonary embolism (PE) within weeks prior to Cycle /Day (C/D) unless adequately treated and considered stable Active thrombosis, or a history of deep vein thrombosis (DVT) or pulmonary embolism (PE) within weeks prior to first administration of study drug unless adequately treated and considered by the Investigator to be stable. History of unprovoked deep vein thrombosis/pulmonary embolism (DVT/PE) in past twelve () months Patients at high-risk for thromboembolic disease, such as those with prior heterotopic ossification (h/o) deep venous thrombosis (DVT). Any history of a venous thromboembolic event (VTE), including deep vein thrombosis\n (DVT) or pulmonary embolism (PE) History of pulmonary embolism within months prior to the first dose of ALRN- or untreated DVT (deep vein thrombosis) History of thromboembolic events and/or bleeding disorders ? days (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) prior to the first dose of study drug None of the following co-morbid conditions:\r\n* Cataracts of grade or greater as per Common Terminology Criteria for Adverse Events (CTCAE) version .\r\n* Retinopathy of grade or greater as per CTCAE version .\r\n** Note: patients that have cataracts that do not require surgery are eligible\r\n** Note: serious adverse events will be reported on CTEP-Adverse Event Reporting System (AERS) using CTCAE version (v).\r\n* Deep vein thrombosis/pulmonary embolism (DVT/PE) within the past months\r\n** Note: patients that are on anticoagulant therapy for maintenance are eligible as long as the DVT and/or PE occurred > months prior to enrollment, and there is no evidence for active thrombosis (either DVT or PE) Patients with the following: \r\n* Bleeding diathesis or patients in whom prophylactic antithrombotic therapy is otherwise contraindicated \r\n* Patients with prior deep vein thrombosis (DVT), pulmonary embolism (PE), or arterial thromboembolism \r\n* Patients with ischemic stroke or transient ischemic attack (TIA) Participants with prior history of thromboembolic disease (i.e. deep venous thrombosis [DVT] or pulmonary embolism [PE] within the last six months) Deep vein thrombosis (DVT)/pulmonary embolism (PE) in the past months Patients with prior deep vein thrombosis (DVT) or pulmonary embolism (PE) currently on anticoagulation regimen will be permitted History of thromboembolic events (e.g., deep vein thrombosis (DVT) or pulmonary embolism (PE)) ? weeks before the first dose of study drug and/or clinical diffuse intravascular coagulation (DIC) Evidence of deep vein thrombosis (DVT) or pulmonary embolism (PE) or other known thromboembolic event present during screening period. Subjects with deep vein thrombosis (DVT) and Pulmonary embolism (PE) within months prior to day treatment Patient at high risk for deep vein thrombosis not willing to take DVT prophylaxis. History of pulmonary embolism or deep vein thrombosis (DVT) within the past months Diagnosed active deep vein thrombosis (DVT) that has not been therapeutically anticoagulated History of thromboembolic events and bleeding disorders ? months (e.g., (deep vein thrombosis) DVT or pulmonary embolism (PE)) History of pulmonary embolism (PE), or untreated deep venous thrombosis (DVT) =< days Patients must not have a prior history of deep vein thrombosis (DVT) or pulmonary embolism in the past years Deep venous thrombosis (DVT) diagnosed within months of study enrollment or history or untreated lower extremity DVT, bone metastases, currently active skin infection, or lymphedema currently involving the treatment field History of deep vein thrombosis (DVT) in the lymphedematous upper extremity Patients with a recent history of deep vein thrombosis (DVT) or pulmonary embolus (PE), in six months prior to enrollment are not eligible for this study Ongoing use or planned peri-operative use of anticoagulants (not including deep vein thrombosis [DVT] prophylaxis) Prior history of documented DVT or PE in the past months Known history of VTE prior to diagnosis (deep vein thrombosis [DVT] or pulmonary embolism PE) due to increased underlying risk of new event Patients who will require anticoagulant medications other than routine deep vein thrombosis (DVT) prophylaxis within days postoperatively