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Myeloma

Pomalidomide (CC4047) plus low dose dexamethasone (Pom/dex) is active and well tolerated in lenalidomide refractory multiple myeloma (MM)

Leukemia volume 24, pages 1934–1939 (2010)Cite this article

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Abstract

Patients with multiple myeloma progressing on current therapies have limited treatment options. Pomalidomide (CC4047), an immunomodulatory drug, has significant activity in relapsed myeloma and previous studies suggest activity in lenalidomide refractory disease. To better define its efficacy in this group, we treated a cohort of lenalidomide refractory patients. Pomalidomide was given orally (2 mg) daily, continuously in 28-day cycles along with dexamethasone (40 mg) given weekly. Responses were assessed by the International Myeloma Working Group Criteria. Thirty-four patients were enrolled. The best response was very good partial response in 3 (9%), partial response (PR) in 8 (23%), best responses (MR) in 5 (15%), stable disease in 12 (35%) and progressive disease in 6 (18%), for an overall response rate of 47%. Of the 14 patients that were considered high risk, 8 (57%) had responses including 4 PR and 4 MR. The median time to response was 2 months and response duration was 9.1 months, respectively. The median overall survival was 13.9 months. Toxicity was primarily hematologic, with grade 3 or 4 toxicity seen in 18 patients (53%) consisting of anemia (12%), thrombocytopenia (9%) and neutropenia (26%). The combination of pomalidomide and dexamethasone (Pom/dex) is highly active and well tolerated in patients with lenalidomide-refractory myeloma.

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Acknowledgements

This trial was funded by Celgene Corporation.

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Authors and Affiliations

  1. Division of Hematology, Mayo Clinic College of Medicine, Rochester, MN, USA

    M Q Lacy, S R Hayman, M A Gertz, K D Short, A Dispenzieri, S Kumar, P R Greipp, J A Lust, S J Russell, D Dingli, S Zeldenrust, S V Rajkumar & F Buadi

  2. Mayo Clinic Arizona, Scottsdale, AZ, USA

    R Fonseca, P L Bergsagel, J R Mikhael & A K Stewart

  3. Mayo Clinic Florida, Jacksonville, FL, USA

    V Roy

  4. Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA

    K Laumann, J B Allred & S J Mandrekar

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  1. M Q Lacy
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  2. S R Hayman
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  3. M A Gertz
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  4. K D Short
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  5. A Dispenzieri
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  6. S Kumar
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  8. J A Lust
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  9. S J Russell
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  10. D Dingli
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  11. S Zeldenrust
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  15. J R Mikhael
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  16. A K Stewart
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  17. K Laumann
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  18. J B Allred
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  19. S J Mandrekar
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  20. S V Rajkumar
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  21. F Buadi
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Corresponding author

Correspondence to M Q Lacy.

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The authors declare no conflict of interest.

Additional information

This study was presented at the American Society of Hematology Annual meeting in New Orleans December 2009.

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Lacy, M., Hayman, S., Gertz, M. et al. Pomalidomide (CC4047) plus low dose dexamethasone (Pom/dex) is active and well tolerated in lenalidomide refractory multiple myeloma (MM). Leukemia 24, 1934–1939 (2010). https://doi.org/10.1038/leu.2010.190

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