Pomalidomide-Based Therapy for Multiple Myeloma: Results From MM-014 Trial
Posted: Monday, July 13, 2020
Treatment with pomalidomide, low-dose dexamethasone, and daratumumab appeared to produce a high overall response rate in patients with relapsed or refractory multiple myeloma, according to Nizar J. Bahlis, MD, of the University of Calgary, Canada, and colleagues. Results of the phase II MM-014 trial, which were published in Leukemia, highlighted that pomalidomide-based therapy may prove to be a safe and effective treatment immediately after first- or second-line lenalidomide failure.
“The antitumor and immune-stimulating properties of pomalidomide are distinct from those of lenalidomide; pomalidomide has different substrate degradation kinetics, increased binding afﬁnity to cereblon, and a different gene-modulation proﬁle,” the investigators remarked. “[The results] indicate that switching from the immunomodulatory agent class [after lenalidomide-based treatment failure] is not necessary.”
A total of 112 patients who presented with relapsed or refractory disease after being treated with a lenalidomide-containing regimen were enrolled. Pomalidomide, low-dose dexamethasone, and daratumumab were administered in 28-day cycles for a median of 14.6, 13.2, and 14.4 months, respectively. Follow-up data were provided for an average of 17.2 months.
The investigators reported an overall response rate of 77.7% in the intention-to-treat population, including 24.1% with a complete response and 50.9% with a very good partial response or better. Approximately 1 year after initiation of treatment, the majority of patients (75.1%) were alive and did not experience disease progression. Pomalidomide-based therapy seemed to provide the greatest benefit to those who received a final dose of lenalidomide of up to 10 mg. Additionally, patients who were treated with lenalidomide for more than 2 years appeared to respond more effectively to the pomalidomide-based regimen than those who were treated with lenalidomide for less than 2 years (overall response rate = 90.9% vs. 64.9%). The majority of patients (99.1%) reported a treatment-emergent adverse event; however, just 31.3% experienced a grade 3 or 4 infection.
Disclosure: For full disclosures of the study authors, visit www.nature.com.