Pomalidomide plus low-dose dexamethasone in myeloma refractory to both bortezomib and lenalidomide: Comparison of 2 dosing strategies in dual-refractory disease

Martha Q. Lacy, Jacob B. Allred, Morie A. Gertz, Suzanne R. Hayman, Kristen Detweiler Short, Francis Buadi, Angela Dispenzieri, Shaji Kumar, Philip R. Greipp, John A. Lust, Stephen J. Russell, David Dingli, Steven Zeldenrust, Rafael Fonseca, P. Leif Bergsagel, Vivek Roy, A. Keith Stewart, Kristina Laumann, Sumithra J. Mandrekar, Craig ReederS. Vincent Rajkumar, Joseph R. Mikhael

Research output: Contribution to journalArticle

174 Scopus citations

Abstract

Pomalidomide at doses of 2 or 4 mg/d has demonstrated excellent activity in patients with multiple myeloma (MM). We opened 2 sequential phase 2 trials using the pomalidomide with weekly dexamethasone (Pom/dex) regimen at differing doses to study the efficacy of this regimen in patients who have failed both lenalidomide and bortezomib. Pomalidomide was given orally 2 or 4 mg daily with dexamethasone 40 mgweekly. Thirty-five patients were enrolled in each cohort. Confirmed responses in the 2-mg cohort consisted of very good partial response (VGPR) in 5 (14%), partial response (PR) in 4 (11%), minor response (MR) in 8 (23%) for an overall response rate of 49%. In the 4-mg cohort, confirmed responses consisted of complete response (CR) in 1 (3%), VGPR in 3 (9%), PR in 6 (17%), MR in 5 (14%) for an overall response rate of 43%. Overall survival at 6 months is 78% and 67% in the 2- and 4-mg cohort, respectively. Myelosuppression was the most common toxicity. This nonrandomized data suggests no advantage for 4 mg over the 2 mg daily. Pomalidomide overcomes resistance in myeloma refractory to both lenalidomide and bortezomib. This trial is registered at http://ClinicalTrials.gov, number NCT00558896.

Original languageEnglish (US)
Pages (from-to)2970-2975
Number of pages6
JournalBlood
Volume118
Issue number11
DOIs
StatePublished - Sep 15 2011

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ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

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