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Szabo AG, Thorsen J, Iversen KF, Levring MB, Helleberg C, Hermansen E, Bønløkke ST, Nielsen K, Teodorescu EM, Kurt E, Strandholdt CN, Vangsted AJ. The real-world use and efficacy of pomalidomide for relapsed and refractory multiple myeloma in the era of CD38 antibodies. EJHAEM 2023; 4:1006-1012. [PMID: 38024635 PMCID: PMC10660104 DOI: 10.1002/jha2.774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/09/2023] [Accepted: 08/12/2023] [Indexed: 12/01/2023]
Abstract
Pomalidomide-dexamethasone (Pd) has been a standard care treatment for relapsed and refractory multiple myeloma since 2013. However, the outcomes of Pd after exposure to CD38 antibodies are not known. Here we describe the real-world use and efficacy of pomalidomide in a Danish, nationwide cohort of daratumumab-exposed patients. We identified 328 patients that were treated with pomalidomide. Of these, 137 received Pd, 65 daratumumab-pomalidomide-dexamethasone (DPd), 43 pomalidomide-cyclophosphamide-dexamethasone (PCd), 19 carfilzomib-pomalidomide-dexamethasone (KPD), 11 pomalidomide-bortezomib-dexamethasone (PVd), and 52 pomalidomide in other combinations. Patients treated with Pd in this cohort had a partial response or better (≥ PR) rate of 35.8% and median time to next treatment (mTNT) of 4.9 months, almost identical to the results of previous prospective clinical trials. Although treatment with the various pomalidomide-containing triplet regimens resulted in higher ≥ PR rates (PCd: 46.5%, PVd: 63.6%, DPd: 55.4%, KPd: 63.2%), the mTNT achieved was not significantly better than with Pd in most cases (PCD: 5.4, PVD: 5.3, DPD: 4.7 months). The exception to this was KPd (mTNT 7.4 months), but this regimen was mainly used earlier in the course of the disease (median time from diagnosis 2.3 years vs. 3.7-4.3 years). The most important predictor of outcomes was not the choice of index regimen (p = 0.72), but prior exposure (p = 0.0116). Compared to CD38 antibody-naïve patients, triple-class-exposed patients achieved reduced ≥ PR rate (38.0% vs. 47.3%), shorter mTNT (4.0 vs. 5.9 months), and shorter median overall survival (12.4 vs. 24.2 months) with pomalidomide treatment.
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Affiliation(s)
- Agoston Gyula Szabo
- Department of HematologyVejle HospitalVejleDenmark
- Department of Hematology, RigshospitaletCopenhagen UniversityCopenhagenDenmark
| | - Jonathan Thorsen
- COPSAC, Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte HospitalUniversity of CopenhagenCopenhagenDenmark
| | | | | | - Carsten Helleberg
- Department of Hematology, RigshospitaletCopenhagen UniversityCopenhagenDenmark
| | - Emil Hermansen
- Department of Hematology, RigshospitaletCopenhagen UniversityCopenhagenDenmark
- Department of HematologyZealand University HospitalRoskildeDenmark
| | | | - Katrine Nielsen
- Department of HematologyAarhus University HospitalAarhusDenmark
| | | | - Eva Kurt
- Department of HematologyRegionshospitalet GødstrupHerningDenmark
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Bertamini L, Bertuglia G, Oliva S. Beyond Clinical Trials in Patients With Multiple Myeloma: A Critical Review of Real-World Results. Front Oncol 2022; 12:844779. [PMID: 35646628 PMCID: PMC9132127 DOI: 10.3389/fonc.2022.844779] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 03/22/2022] [Indexed: 12/22/2022] Open
Abstract
The current strategies for the treatment of multiple myeloma (MM) have improved, thanks to effective drug classes and combination therapies, for both the upfront and relapsed settings. Clinical trials for newly diagnosed transplant-ineligible patients led to the approval of immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) in combination with anti-CD38 monoclonal antibodies (mAbs), to be administered during the induction phase before transplantation and during maintenance treatment, with lenalidomide recommended until relapse. In relapsed/refractory patients, the complex treatment scenario currently includes several options, such as triplets with anti-CD38 mAbs plus IMiDs or PIs, and novel targeted molecules. Comparisons among clinical trials and real-world data showed a good degree of reproducibility of some important results, particularly in terms of overall response rate, progression-free survival, and overall survival. This may help clinicians towards a proper selection of the best treatment options, particularly in real-world settings. However, as compared with the management of real-world settings, clinical trials have some pitfalls in terms of outcome and especially in terms of safety and quality of life. In fact, trials include younger and presumably healthier patients, excluding those with worst clinical conditions due to MM features (e.g., renal insufficiency or bone disease, which can impair the performance status) and comorbidities (e.g., cardiac and pulmonary disease), thus resulting in a possible lack of representativeness of data about the patients enrolled. In this review, we analyze comparable and discrepant results from clinical trials vs. real-world settings published in the last 10 years, focusing on different drugs and combinations for the treatment of MM and providing an overview of treatment choices.
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Affiliation(s)
| | | | - Stefania Oliva
- SSD Clinical Trial in Oncoematologia e Mieloma Multiplo, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy
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3
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Dechow T, Aldaoud A, Behlendorf T, Knauf W, Eschenburg H, Groschek M, Hansen R, Söling U, Grebhardt S, Siebenbach HU, Vannier C, Potthoff K. Pomalidomide plus dexamethasone for patients with relapsed or refractory multiple myeloma: Final results of the non-interventional study POSEIDON and comparison with the pivotal phase 3 clinical trials. Eur J Haematol 2021; 108:133-144. [PMID: 34714555 PMCID: PMC9298817 DOI: 10.1111/ejh.13719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 10/18/2021] [Accepted: 10/25/2021] [Indexed: 12/30/2022]
Abstract
Background Prognosis of patients with multiple myeloma (MM) who have relapsed on or become refractory to immunomodulators and bortezomib is poor, and treatment options are limited. While pomalidomide plus low‐dose dexamethasone (POM/DEX) has demonstrated efficacy in clinical trials, real‐world evidence is scarce. Patients and Methods POSEIDON was a prospective non‐interventional study designed to evaluate effectiveness, safety and quality of life (QoL) of POM/DEX in patients with relapsed or refractory MM (R/RMM) pretreated with at least two prior therapy lines including both lenalidomide and bortezomib in real world in Germany. Patients received POM/DEX according to physicians’ choice. Data were analyzed descriptively. Results Between 2014 and 2017, 151 patients were enrolled, 144 patients with a median of three prior therapy lines qualified for effectiveness analysis. Median age was 73.2 years. Median progression‐free and overall survival were 6.3 months [95% confidence interval (CI) 5.2, 8.6] and 12.9 months [95% CI 10.6, 15.1]. Most frequent grade 3/4 adverse events were leukopenia (8.2%), pneumonia (7.5%) and anemia (5.5%). QoL was maintained after start of POM/DEX. Conclusion The results of POSEIDON support the effectiveness and safety of POM/DEX in R/RMM patients pretreated with lenalidomide and bortezomib and highlight the clinical value of the POM/DEX regimen in the real‐world setting. Registered at clinicaltrials.gov (NCT02075996).
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Affiliation(s)
| | - Ali Aldaoud
- Gemeinschaftspraxis für Hämatologie & Onkologie, Leipzig, Germany
| | - Timo Behlendorf
- Gemeinschaftspraxis für Innere Medizin, Hämatologie & Onkologie, Halle (Saale), Germany
| | - Wolfgang Knauf
- Centrum für Hämatologie und Onkologie Bethanien, Frankfurt am Main, Germany
| | | | | | - Richard Hansen
- Schwerpunktpraxis für Hämatologie und Onkologie, Kaiserlautern, Germany
| | - Ulrike Söling
- Hämato-onkologisches Zentrum Kassel GmbH, Kassel, Germany
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Hung YC, Gau JP, Huang SY, Ko BS, Teng CLJ. Pomalidomide and Dexamethasone Are Effective in Relapsed or Refractory Multiple Myeloma in a Real-Life Setting: A Multicenter Retrospective Study in Taiwan. Front Oncol 2021; 11:695410. [PMID: 34123862 PMCID: PMC8193980 DOI: 10.3389/fonc.2021.695410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 05/14/2021] [Indexed: 11/30/2022] Open
Abstract
Background The therapeutic options of relapsed or refractory multiple myeloma (RRMM) remain a challenge. The MM-003 trial demonstrated that RRMM patients treated with pomalidomide and dexamethasone (Pom/Dex) have better progression-free survival (PFS) than those treated with high-dose dexamethasone alone. However, the real-world effectiveness of Pom/Dex in these patients in Taiwan remains unclear. Methods This multicenter, registry-based study retrospectively reviewed the medical records of 49 consecutive patients undergoing Pom/Dex treatment for RRMM. We investigated the overall response rate (ORR) and PFS in these patients. The patients were stratified into two groups: those who received two (n=33) and those who received more than two (n=16) prior lines of treatment according to the numbers of regimens before Pom/Dex therapy. The differences in ORR and PFS between these two groups were further analyzed. We also analyzed factors attributed to disease progression. Results The ORR was 47.7%, and the median PFS was 4.0 months (range, 0.1−21.1). Patients who received two prior lines of treatment had a higher ORR than those who received more than two prior lines of treatment (55.2% vs. 33.3%; p=0.045). The median PFS of these groups was 4.8 and 3.9 months, respectively (p=0.805). Primary lenalidomide refractoriness reduced the risk of myeloma progression following Pom/Dex treatment (hazard ratio, 0.14; p=0.001). Conclusions The median PFS following Pom/Dex treatment in Taiwanese RRMM patients in a real-world setting was similar to that reported by the MM-003 trial. Primary lenalidomide refractoriness should not be an obstacle for Pom/Dex treatment in RRMM.
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Affiliation(s)
- Yu-Chin Hung
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Yunlin, Taiwan
| | - Jyh-Pyng Gau
- Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shang-Yi Huang
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Bor-Sheng Ko
- Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Department of Hematological Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chieh-Lin Jerry Teng
- Division of Hematology/Medical Oncology, Department of Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Life Science, Tunghai University, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
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5
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Bondili SK, Bagal B, Zawar A, Ventrapati P, Thorat J, Gokarn A, Punatar S, Nayak L, Bonda A, Jain H, Sengar M, Khattry N. Real-World Outcomes With Generic Pomalidomide in Relapsed Refractory Multiple Myeloma-Experience From a Tertiary Care Cancer Center. JCO Glob Oncol 2021; 7:361-367. [PMID: 33689483 PMCID: PMC8081531 DOI: 10.1200/go.20.00228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
PURPOSE The prognosis of relapsed and refractory multiple myeloma (RRMM) that is refractory to bortezomib and lenalidomide is very poor wherein the median survival is between 3 and 9 months. We did this retrospective analysis to study the pattern of utilization, tolerance, and outcomes with pomalidomide in these patients having RRMM. MATERIALS AND METHODS Retrospective analysis of all the patients who were treated with generic pomalidomide at Tata Memorial Centre, Mumbai, during the period of May 2017 to March 2019 was done. Patients with secretory disease and who had completed at least one cycle of pomalidomide were analyzed for response rates, toxicity, and survival outcomes. RESULTS A total of 81 patients received pomalidomide-based therapy during this study period, out of which 75 were included in the survival analysis. Forty-eight patients (59.3%) were refractory to both lenalidomide and bortezomib. Overall response rate was 58.7%. Five patients (6.7%) achieved complete response, very good partial response was seen in 13 patients (17.3%), and partial response was seen in 26 patients (34.7%). After a median follow-up of 11 months (range 2-27 months), median progression-free survival was 9.1 months (95% CI, 5.4 to 12.9 months). Median progression-free survival for patients who were refractory to both lenalidomide and bortezomib versus nonrefractory was 5.5 and 12.6 months, respectively, which was significant statistically (P = .04, hazard ratio, 0.35, 95% CI, 0.28 to 0.97). The median overall survival was not reached. Important toxicities included anemia (28%), neutropenia (16%), pneumonia (16%), and venous thrombosis (5%). CONCLUSION Generic pomalidomide-based therapy is an effective option and is well tolerated in patients with RRMM. Higher response rates and longer survival seen in our study are possibly because of heterogeneity of the study population.
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Affiliation(s)
- Suresh Kumar Bondili
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Bhausaheb Bagal
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Abhinav Zawar
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Pradeep Ventrapati
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Jayashree Thorat
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Anant Gokarn
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Sachin Punatar
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Lingaraj Nayak
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Avinash Bonda
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Hashmukh Jain
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Manju Sengar
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
| | - Navin Khattry
- Department of Medical Oncology, Tata Memorial Hospital, Parel, and Homi Bhabha National Institute, Mumbai, Maharashtra, India
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6
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Clinical Benefit of Long-Term Disease Control with Pomalidomide and Dexamethasone in Relapsed/Refractory Multiple Myeloma Patients. J Clin Med 2019; 8:jcm8101695. [PMID: 31623097 PMCID: PMC6832641 DOI: 10.3390/jcm8101695] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/25/2022] Open
Abstract
Background: We retrospectively analysed relapsed/refractory MM (RRMM) patients treated with pomalidomide and dexamethasone (PomaD) either in real life, or previously enrolled in an interventional (STRATUS, MM-010) or currently enrolled in an observational study (MM-015) to provide further insights on safety and tolerability and clinical efficacy. Methods: Between July 2013 and July 2018, 76 RRMM patients (including 33 double refractory MM) received pomalidomide 4 mg daily given orally on days 1–21 of each 28-day cycle, and dexamethasone 40 mg weekly (≤75 years) or 20 mg weekly for patients aged > 75 years. In nine patients a third agent was added to increase the response: Cyclophosphamide (in two fit patients) or clarithromycin (in seven frail patients). Patients received subcutaneous filgrastim as part of the prophylaxis regimen for neutropenia. Results: A median number of six (range 2–21) PomaD cycles were given. The regimen was well tolerated with grade 3–4 haematological and non-haematological adverse events in 39 (51%) and 25 (33%) patients, respectively. In patients who developed serious AE, pomalidomide dose reduction (11%, 14%) or definitive discontinuation (18%, 23%) were applied. All patients have been evaluated for response within the first two cycles. The disease control rate (DCR), i.e., those patients that had a response equal or better than stable disease (≥ SD), was high (89%), with 44% overall response rate (ORR) after six cycles. The achieved best responses were complete remission (CR, 5%), very good partial remission (VGPR, 4%), partial remission (PR, 35%), minimal response (MR, 7%), and stable disease (SD, 38%). After a median follow up of 19.6 months, median progression free survival was 9.4 months, and overall survival (OS) was 19.02 months. Univariate analysis showed that double refractory patients, or who received more than three previous lines had shorter PFS. At 18 months, regardless of the depth of response, patients with a disease control of at least six months, defined as maintenance of a best clinical and/or biochemical response to treatment for almost six months, had prolonged PFS (35.3% versus 20.6%, p = 0.0003) and OS (81.2% versus 15.9%, p < 0.0001) Conclusions: Our findings indicate that PomaD is a safe and well-tolerated regimen in real-life, associated with prolonged PFS and OS with acceptable toxicity. Moreover, Pd induced disease control in most intensively pre-treated patients and some of them achieved longer PFS than that obtained with the previous treatment.
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7
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Mele G, Pastore D, Di Renzo N, Fragasso A, Guarini A, Mazza P, Musto P, Pavone V, Tarantini G, Curci P, Falcone AP, Mele A, Miccolis MR, Palazzo G, Palumbo G, Quinto AM, Reddiconto G, Rizzi R, Cascavilla N, Specchia G, Capalbo SF. Real world Italian experience of pomalidomide plus low-dose dexamethasone in the relapsed and refractory myeloma setting: extended follow-up of a retrospective multicenter study by the 'Rete Ematologica Pugliese E Basilicata'. Leuk Lymphoma 2019; 60:3565-3568. [PMID: 31286780 DOI: 10.1080/10428194.2019.1636989] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- Giuseppe Mele
- Haematology and BMT Unit, Ospedale Antonio Perrino, Brindisi, Italy
| | - Domenico Pastore
- Haematology and BMT Unit, Ospedale Antonio Perrino, Brindisi, Italy
| | | | - Alberto Fragasso
- Haematology and BMT Unit, Ospedale Madonna delle Grazie, Matera, Italy
| | - Attilio Guarini
- Haematology and BMT Unit, Ospedale Giovanni Paolo II, Bari, Italy
| | - Patrizio Mazza
- Haematology and BMT Unit, Ospedale Giuseppe Moscati, Taranto, Italy
| | - Pellegrino Musto
- Haematology and BMT Unit, Centro di Riferimento Oncologico della Basilicata, Rionero in Vulture, Italy
| | - Vincenzo Pavone
- Haematology and BMT Unit, Ospedale Cardinale Panico, Tricase, Italy
| | - Giuseppe Tarantini
- Haematology and BMT Unit, Ospedale Monsignor R. Dimiccoli, Barletta, Italy
| | - Paola Curci
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Antonietta Pia Falcone
- Haematology and BMT Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Anna Mele
- Haematology and BMT Unit, Ospedale Cardinale Panico, Tricase, Italy
| | | | - Giulia Palazzo
- Haematology and BMT Unit, Ospedale Giuseppe Moscati, Taranto, Italy
| | - Gaetano Palumbo
- Haematology and BMT Unit, Ospedali Riuniti-Azienda Ospedaliera Universitaria, Foggia, Italy
| | | | | | - Rita Rizzi
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Nicola Cascavilla
- Haematology and BMT Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Giorgina Specchia
- Haematology and BMT Unit, University of Bari Medical School, Policlinico, Italy
| | - Silvana Franca Capalbo
- Haematology and BMT Unit, Ospedali Riuniti-Azienda Ospedaliera Universitaria, Foggia, Italy
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8
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Joshua DE, Bryant C, Dix C, Gibson J, Ho J. Biology and therapy of multiple myeloma. Med J Aust 2019; 210:375-380. [DOI: 10.5694/mja2.50129] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | | | | | | | - Joy Ho
- Royal Prince Alfred Hospital Sydney NSW
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9
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Jandial A, Mishra K, Lad D, Prakash G, Khadwal A, Malhotra P. Real world experience with "generic" pomalidomide in relapsed refractory multiple myeloma. Leuk Lymphoma 2018; 60:1102-1104. [PMID: 30322320 DOI: 10.1080/10428194.2018.1508675] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Aditya Jandial
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
| | - Kundan Mishra
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
| | - Deepesh Lad
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
| | - Gaurav Prakash
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
| | - Alka Khadwal
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
| | - Pankaj Malhotra
- a Clinical Hematology Division, Department of Internal Medicine, PGIMER , Chandigarh , India
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10
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Scott AP, Mollee P. Pomalidomide - Author Reply. Leuk Lymphoma 2018; 60:1105. [PMID: 30277106 DOI: 10.1080/10428194.2018.1516884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Ashleigh P Scott
- a Royal Brisbane and Women's Hospital , Brisbane , Australia.,b School of Medicine, University of Queensland , Brisbane , Australia
| | - Peter Mollee
- b School of Medicine, University of Queensland , Brisbane , Australia.,c Princess Alexandra Hospital , Brisbane , Australia
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11
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Charlinski G, Grzasko N, Jurczyszyn A, Janczarski M, Szeremet A, Waszczuk-Gajda A, Bernatowicz P, Swiderska A, Guzicka-Kazimierczak R, Lech-Maranda E, Szczepaniak A, Wichary R, Dmoszynska A. The efficacy and safety of pomalidomide in relapsed/refractory multiple myeloma in a "real-world" study: Polish Myeloma Group experience. Eur J Haematol 2018; 101:354-361. [PMID: 29882602 DOI: 10.1111/ejh.13106] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Patients with relapsed/refractory multiple myeloma (RRMM) have poor prognosis. Pomalidomide is an immunomodulatory compound that has demonstrated activity in MM patients with disease refractory to lenalidomide and bortezomib. OBJECTIVES Participants of clinical trials are highly selected populations; therefore, the aim of this study was to present observations from real practice that might provide important information for practitioners. PATIENTS AND METHODS We analyzed retrospectively 50 patients treated with pomalidomide in 12 Polish sites between 2014 and 2017. Median age was 63 years, median time since diagnosis 4.5 years and median number of prior regimens 4. RESULTS The overall response rate was 39.1%. Median progression-free survival (PFS) and overall survival (OS) were 10.0 and 14.0 months, respectively. Previous treatment with immunomodulatory drugs, bortezomib or stem cell transplant had no impact on PFS and OS. Most frequent grade 3/4 treatment-emergent adverse events were hematologic (neutropenia 24.0%, thrombocytopenia 10.0%, anemia 8.0%). Most common grade 3/4 non-hematologic toxicities were respiratory tract infection (14.0%) and neuropathy (4.0%). CONCLUSIONS This real-world data have confirmed that pomalidomide is an active drug in RRMM and support results of published clinical trials and other real-world studies.
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Affiliation(s)
| | - Norbert Grzasko
- Department of Hematology, St. John's Cancer Center, Lublin, Poland.,Department of Experimental Hematooncology, Medical University of Lublin, Lublin, Poland
| | - Artur Jurczyszyn
- Department of Hematology, Jagiellonian University Medical College, Krakow, Poland
| | - Mariusz Janczarski
- Department of Oncology and Hematology, Central Clinical Hospital of the Ministry of Interior and Administration, Warsaw, Poland
| | - Agnieszka Szeremet
- Department of Hematology, Blood Neoplasms and Bone Marrow Transplantation, Medical University, Wroclaw, Poland
| | - Anna Waszczuk-Gajda
- Department of Hematology, Oncology and Internal Diseases Medical, University of Warsaw, Warsaw, Poland
| | - Paweł Bernatowicz
- Department of Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Alina Swiderska
- Clinical Department of Hematology, University Hospital, Zielona Gora, Poland
| | | | - Ewa Lech-Maranda
- Department of Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
| | - Andrzej Szczepaniak
- Department of Hematology and Bone Marrow Transplantation, University of Medical Sciences, Poznan, Poland
| | - Ryszard Wichary
- Department of Hematology and Bone Marrow Transplantation, Medical University of Silesia, Katowice, Poland
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