Pomalidomide with or without dexamethasone for relapsed/refractory multiple myeloma in Japan: a retrospective analysis by the Kansai Myeloma Forum

被引：0
作者：
Yayoi Matsumura-Kimoto
Junya Kuroda
Hitomi Kaneko
Yuri Kamitsuji
Shin-ichi Fuchida
Aya Nakaya
Hirohiko Shibayama
Nobuhiko Uoshima
Isao Yokota
Hitoji Uchiyama
Hideo Yagi
Satoru Kosugi
Toshimitsu Matsui
Jun Ishikawa
Mitsuhiro Matsuda
Kensuke Ohta
Masato Iida
Hirokazu Tanaka
Masayuki Kobayashi
Katsuya Wada
Chihiro Shimazaki
Shosaku Nomura
Kazunori Imada
Masayuki Hino
Itaru Matsumura
Yuzuru Kanakura
Akifumi Takaori-Kondo
机构：
[1] Kyoto Prefectural University of Medicine,Division of Hematology and Oncology, Department of Medicine
[2] Japanese Red Cross Osaka Hospital,Department of Hematology
[3] Matsushita Memorial Hospital,Department of Hematology
[4] Japan Community Health Care Organization Kyoto Kuramaguchi Medical Center,Department of Hematology
[5] Kansai Medical University,First Department of Internal Medicine
[6] Osaka University Graduate School of Medicine,Department of Hematology and Oncology
[7] Japanese Red Cross Kyoto Daini Hospital,Department of Hematology
[8] Kyoto Prefectural University of Medicine,Department of Biostatistics, Graduate School of Medical Science
[9] Japanese Red Cross Kyoto Daiichi Hospital,Department of Hematology
[10] Kinki University School of Medicine,Division of Hematology, Nara Hospital
[11] Toyonaka Municipal Hospital,Department of Hematology
[12] Nishiwaki Municipal Hospital,Department of Hematology
[13] Osaka Medical Center for Cancer and Cardiovascular Disease,Department of Hematology and Oncology
[14] PL General Hospital,Department of Hematology
[15] Osaka Saiseikai Nakatsu Hospital,Department of Hematology
[16] Kawasaki Hospital,Department of Hematology and Oncology
[17] Kinki University,Division of Hematology and Rheumatology, Department of Internal Medicine, Faculty of Medicine
[18] Kyoto University,Department of Hematology and Oncology
[19] Osaka City University,Department of Hematology, Graduate School of Medicine
来源：
International Journal of Hematology | 2018年 / 107卷
关键词：
Multiple myeloma; Pomalidomide; Efficacy; Adverse events;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Determinants of the efficacy and safety of pomalidomide (POM) monotherapy or POM plus dexamethasone (DEX) (POM/DEX) for relapsed and refractory multiple myeloma (RRMM) were examined retrospectively in a real-world clinical practice setting in Japan. The subjects were 108 patients registered with the Kansai Myeloma Forum, who were treated with either POM or POM/DEX. Of these, 79 (73%), 73 (68%), and 58 (54%) were resistant to bortezomib (BTZ), lenalidomide (LEN), and both BTZ and LEN, respectively. The median overall survival (OS) was not reached. The median time to treatment failure (TTF) was 4.4 months. The best response was recorded in 96 patients, with a 31% overall response rate (ORR) and a 79% rate of achieving at least stable disease. Number of pre-POM regimens ≥ 5, non-IgG-type M-protein, and time from initial therapy to POM or POM/DEX therapy < 2 years were associated with shorter TTF and OS. Frequent (> 10%) severe adverse events included neutropenia (55.1%), thrombocytopenia (33.7%), anemia (30.6%), febrile neutropenia (12.2%), fatigue (11.2%), and anorexia (10.2%). In conclusion, POM and POM/DEX showed substantial efficacy against RRMM, but new combination therapies with POM are needed to improve efficacy further without causing hematologic toxicities.
引用
收藏
页码：541 / 550
页数：9
相关论文
共 170 条
  • [1] Laubach J(2016)Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group Leukemia 30 1005-1017
  • [2] Garderet L(2016)Pooled analysis of the reports of pomalidomide after failure of lenalidomide and (or) bortezomib for multiple myeloma Hematol Oncol 34 102-107
  • [3] Mahindra A(2016)Safe and prolonged survival with long-term exposure to pomalidomide in relapsed/refractory myeloma Ann Oncol 27 902-907
  • [4] Gahrton G(2015)Proteasome inhibitors block Ikaros degradation by lenalidomide in multiple myeloma Haematologica 100 e315-e317
  • [5] Caers J(2014)Immunomodulatory agents lenalidomide and pomalidomide co-stimulate T cells by inducing degradation of T cell repressors Ikaros and Aiolos via modulation of the E3 ubiquitin ligase complex CRL4(CRBN) Br J Haematol 164 811-821
  • [6] Sezer O(2016)Mechanisms of action and resistance for multiple myeloma novel drug treatments In t J Hematol 104 271-272
  • [7] Sheng Z(2016)Cereblon and its downstream substrates as molecular target of immunomodulatory drugs Int J Hematol 104 293-299
  • [8] Liu G(2013)Pomalidomide plus low-dose dexamethasone is active and well tolerated in bortezomib and lenalidomide-refractory multiple myeloma: intergroupe Francophone du Myelome 2009-02 Blood 121 1968-1975
  • [9] Fouquet G(2013)Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): a randomised, open-label, phase 3 trial Lancet Oncol 14 1055-1066
  • [10] Pegourie B(2017)The efficacy and tolerability of pomalidomide in relapsed/refractory myeloma patients in a “real-world” study: the Royal Marsden Hospital experience Leuk Lymphoma 58 494-497
12345678910