TY - JOUR
T1 - Pomalidomide and its clinical potential for relapsed or refractory multiple myeloma
T2 - An update for the hematologist
AU - Mccurdy, Arleigh R.
AU - Lacy, Martha Q.
N1 - Funding Information:
Pomalidomide is a third-generation immunomodulatory agent with significant activity in MM. It has shown impressive results in patients who are refractory to lenalidomide, suggesting non-cross-resistance. It also has activity in patients refractory to both lenalidomide and bortezomib, with 26% of patients achieving at least a PR and remission duration of 12 months [ Lacy et al . 2011 ]. Response rates of 74% in patients with high risk cytogenetic or molecular markers provide a viable option in this group of patients who are often challenging to treat at relapse [ Lacy et al . 2009 ]. No prospective randomized studies have delineated optimal dose, however, available data suggests that efficacy and toxicity are similar at the 2 and 4 mg dose levels. Pomalidomide is well tolerated, minimally toxic, and easy to use, which are important features of a drug used in heavily treated, multiply relapsed patients. Funding Martha Q. Lacy has received funding for clinical trials from Celgene. Conflict of interest statement The authors declare no conflicts of interest in preparing this article.
PY - 2013/6
Y1 - 2013/6
N2 - Multiple myeloma is a common plasma cell neoplasm that is incurable with conventional therapy. The treatment paradigm of multiple myeloma is not standardized and is evolving. The advent of novel drugs, including the proteasome inhibitor bortezomib and the immunomodulatory agents, has resulted in increased median survival. Unfortunately, all patients eventually relapse and require further therapy. Pomalidomide is the newest immunomodulatory drug, created by chemical modification of thalidomide with the intention of increasing therapeutic activity while limiting toxicity. Its mechanism of action is incompletely understood but involves anti-angiogenic effects, immunomodulation, an effect on the myeloma tumor microenvironment, and the protein cereblon. It is more potent than thalidomide and lenalidomide. In phase II studies, it has shown significant activity in patients with relapsed and refractory multiple myeloma, including patients who are heavily pretreated, have disease refractory to lenalidomide and bortezomib, and those with high-risk cytogenetic or molecular markers. It is generally well tolerated, with adverse effects including fatigue, neutropenia, neuropathy, and thromboembolic disease. Pomalidomide is a promising new agent in the expanding arsenal of antimyeloma drugs. In this review, we discuss the clinical experience to date with pomalidomide in multiple myeloma.
AB - Multiple myeloma is a common plasma cell neoplasm that is incurable with conventional therapy. The treatment paradigm of multiple myeloma is not standardized and is evolving. The advent of novel drugs, including the proteasome inhibitor bortezomib and the immunomodulatory agents, has resulted in increased median survival. Unfortunately, all patients eventually relapse and require further therapy. Pomalidomide is the newest immunomodulatory drug, created by chemical modification of thalidomide with the intention of increasing therapeutic activity while limiting toxicity. Its mechanism of action is incompletely understood but involves anti-angiogenic effects, immunomodulation, an effect on the myeloma tumor microenvironment, and the protein cereblon. It is more potent than thalidomide and lenalidomide. In phase II studies, it has shown significant activity in patients with relapsed and refractory multiple myeloma, including patients who are heavily pretreated, have disease refractory to lenalidomide and bortezomib, and those with high-risk cytogenetic or molecular markers. It is generally well tolerated, with adverse effects including fatigue, neutropenia, neuropathy, and thromboembolic disease. Pomalidomide is a promising new agent in the expanding arsenal of antimyeloma drugs. In this review, we discuss the clinical experience to date with pomalidomide in multiple myeloma.
KW - multiple myeloma
KW - pomalidomide
KW - treatment
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U2 - 10.1177/2040620713480155
DO - 10.1177/2040620713480155
M3 - Review article
AN - SCOPUS:84993710061
SN - 2040-6207
VL - 4
SP - 211
EP - 216
JO - Therapeutic Advances in Hematology
JF - Therapeutic Advances in Hematology
IS - 3
ER -