Pomalidomide, bortezomib, and dexamethasone for multiple myeloma previously treated with lenalidomide (OPTIMISMM): outcomes by prior treatment at first relapse
Meletios Dimopoulos 1 , Katja Weisel 2 , Philippe Moreau 3 , Larry D Anderson Jr 4 , Darrell White 5 , Jesus San-Miguel 6 , Pieter Sonneveld 7 , Monika Engelhardt 8 , Matthew Jenner 9 , Alessandro Corso 10 , Jan Dürig 11 , Michel Pavic 12 , Morten Salomo 13 , Eva Casal 14 , Shankar Srinivasan 14 , Xin Yu 14 , Tuong Vi Nguyen 14 , Tsvetan Biyukov 15 , Teresa Peluso 15 , Paul Richardson 16
In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone (PVd) demonstrated superior efficacy vs bortezomib and dexamethasone (Vd) in patients with relapsed or refractory multiple myeloma previously treated with lenalidomide, including those refractory to lenalidomide.
This analysis evaluated outcomes in patients at first relapse (N = 226) by lenalidomide-refractory status, prior bortezomib exposure, and prior stem cell transplant (SCT). Second-line PVd significantly improved PFS vs Vd in lenalidomide-refractory (17.8 vs 9.5 months; P = 0.0276) and lenalidomide-nonrefractory patients (22.0 vs 12.0 months; P = 0.0491), patients with prior bortezomib (17.8 vs 12.0 months; P = 0.0068), and patients with (22.0 vs 13.8 months; P = 0.0241) or without (16.5 vs 9.5 months; P = 0.0454) prior SCT. In patients without prior bortezomib, median PFS was 20.7 vs 9.5 months (P = 0.1055).
Significant improvement in overall response rate was also observed with PVd vs Vd in lenalidomide-refractory (85.9% vs 50.8%; P < 0.001) and lenalidomide-nonrefractory (95.7% vs 60.0%; P < 0.001) patients, with similar results regardless of prior bortezomib or SCT. No new safety signals were observed.
These data demonstrate the benefit of PVd at first relapse, including immediately after upfront lenalidomide treatment failure and other common first-line treatments.
CITA DEL ARTÍCULO Leukemia. 2020 Sep 7. doi: 10.1038/s41375-020-01021-3