Pomalidomide Plus Low-Dose Dexamethasone in Relapsed/Refractory Multiple Myeloma Patients: Results of the Real-World “POWERFUL” Study

Abstract

The “POWERFUL” multicenter, retrospective, and prospective study investigated the effectiveness of pomalidomide plus low-dose dexamethasone (POM/LoDex) therapy in relapsed/refractory multiple myeloma in routine care in Greece. Ninety-nine eligible adult patients treated with POM/LoDex according to the approved label after having received ≥2 prior therapies, including lenalidomide and bortezomib, were consecutively enrolled between 16 November 2017 and 21 February 2019 in 18 hematology departments. Fifty patients (50.5%) started POM/LoDex as third-line treatment. During the treatment period (median: 8.3 months; range: 0.3–47.6 months), the median POM dose was 4 mg/day, and 31.3% of the patients received additional antimyeloma agents. The overall response rate was 32.3%. During a median follow-up period of 13.8 months (Kaplan–Meier estimate), the median progression-free survival (PFS) was 10.5 months (95% CI: 7.4–14.4). The PFS was not significantly different between patients receiving POM/LoDex in the third versus later line of therapy, nor between patients receiving concomitant antimyeloma therapy versus POM/LoDEx doublet. During the prospective safety data collection period (median: 7.6 months) among patients with prospective follow-up (N = 75), POM-related adverse event incidence rate was 42.7% (serious: 18.7%; grade ≥ 3 hematological POM-related adverse events: 8.0%). Only neutropenia (13.3%) was reported at a frequency ≥10%. In conclusion, in this real-world study, POM/LoDex displayed a long PFS with no new safety signals emerging.

Clinical outcomes of pomalidomide‐based and daratumumab‐based therapies in patients with relapsed/refractory multiple myeloma: A real‐world cohort study in China

“…The pooled data showed an ORR of 47.1% across all Pom‐based regimens 36 . Real‐world studies in the United Kingdom, 37 Poland, 38 India, 39 and Greece 40 also reported the promising clinical effectiveness of Pom‐based regimens, with ORR ranging from 39.1% to 58.7% and the median PFS ranging from 5.2 months to 10.5 months. Our cohort represents a real‐world Chinese patient population, most of whom had previous treatment (87.1% and 100%) and were refractory (72.1% and 70.0%) to lenalidomide or PIs.…”

Genome Instability in Multiple Myeloma: Facts and Factors

“…IMiDs are derivatives of the teratogenic drug thalidomide that are approved by the US FDA for the treatment of MM [ 87 , 120 , 177 , 178 , 179 , 180 , 181 , 182 ]. Lenalidomide is the standard-of-care maintenance therapy for patients with standard risk and after ASCT [ 87 , 97 , 183 , 184 , 185 , 186 , 187 , 188 ].…”