Pomalidomide, Cyclophosphamide, and Dexamethasone for the Treatment of Relapsed/Refractory Multiple Myeloma: Real-World Analysis of the Pethema-GEM Experience
Paula Rodriguez-Otero 1 , Maialen Sirvent 2 , Ana Pilar González-Rodríguez 3 , Esperanza Lavilla 4 , Alfonso García de Coca 5 , José María Arguiñano 6 , Josep M Martí 7 , Valentin Cabañas 8 , Cristina Motlló 9 , Erik de Cabo 10 , Cristina Encinas 11 , Ilda Murillo 12 , Jose Ángel Hernández-Rivas 13 , Ernesto Pérez-Persona 14 , Felipe Casado 15 , Antonia Sampol 16 , Ricarda García 17 , María Jesús Blanchard 18 , Magdalena Anguita 19 , Ana Paz Lafuente 20 , Belén Iñigo 21 , Aurelio López 22 , Paz Ribas 23 , Mario Arnao 24 , Roberto Maldonado 25 , Joan Bladé 26 , María Victoria Mateos 27 , Juan José Lahuerta 28 , Jesús F San Miguel 29
Introduction: Treatment of relapsed/refractory multiple myeloma (RRMM) is highly challenging, especially for patients with disease refractory to initial therapy, and in particular for disease developing refractoriness to lenalidomide. Indeed, with currently approved treatments, median progression-free survival (PFS) in the lenalidomide-refractory setting is less than 10 months, reflecting the difficulty in treating this patient population.
Pomalidomide is a second-generation immunomodulatory drug that has shown activity in lenalidomide-refractory disease in the setting of different combinations.
Patients and methods: A real-world study was conducted by the Spanish Myeloma group in a cohort of patients with RRMM treated with pomalidomide, cyclophosphamide, and dexamethasone (PomCiDex). One hundred patients were treated with a median of 3 prior lines of therapy.
Results: Overall response rate was 39%, with a clinical benefit rate of 93%. Median PFS was 7.6 months; median overall survival (OS) was 12.6 months. Median PFS and OS survival were consistent across the different subgroups analyzed. Prolonged PFS and OS were found in patients with responsive disease.
Conclusion: Our results compared favorably with those obtained with different pomalidomide-based combinations in a similar patient population. PomCiDex remains a manageable, cost-effective, and all-oral triplet combination for RRMM patients.
CITATION Clin Lymphoma Myeloma Leuk. 2021 Jun;21(6):413-420. doi: 10.1016/j.clml.2021.02.004. Epub 2021 Feb 16.