Treatment Tolerability in Patients With Relapsed or Refractory Multiple Myeloma
Patients with relapsed or refractory multiple myeloma who received treatment with lenalidomide appeared to respond to and tolerate combination treatment with pomalidomide, bortezomib, and dexamethasone (PVD). Jonas Paludo, MD, of the Mayo Clinic in Rochester, Minnesota, led the phase I/II study, which evaluated the maximum tolerated doses, safety, and efficacy of the therapy. These results were published in Blood.
Based on the mSMART criteria of classification of relapsed myeloma, 24% of 50 patients were found to be at high risk. The objective response rate was 86% among the entire pool and 100% among high-risk patients. At a median follow-up of 42 months, 20% remained progression-free, 66% were alive, and 4% remained on treatment. Weekly administration of bortezomib seemed to improve tolerability and convenience.
The most common toxicities associated with the combination therapy were neutropenia (96%), leukopenia (84%), thrombocytopenia (82%), anemia (74%), and fatigue (72%), although most of them were grade 1/2. Grade 3 and 4 toxicities included neutropenia (70%), leukopenia (36%), and lymphopenia (20%). Five patients experienced deep vein thrombosis.