ABSTRACT
Objective:To investigate the therapeutic effect and safety of pomadomide combined with cyclophosphamide and dexamethasone (PCD) in the treatment of relapsed/refractory multiple myeloma (MM).Methods:The clinical data of 20 relapsed/refractory MM patients receiving PCD regimen in the Second People's Hospital of Lianyungang Affiliated to Bengbu Medical College from March 2021 to June 2022 were retrospectively analyzed; and 29 relapsed/refractory MM patients receiving other regimens including DECP (dexamethasone+etoposide+cyclophosphamide+cisplatin, 13 cases) and VCD (bortezomib+ cyclophosphamide+ dexamethasone, 16 cases) during the same period were treated as the control group. The efficacy and adverse effects of both groups were compared after 4 cycles of treatment.Results:After 4 cycles of treatment, the overall response rate (ORR) and the clinical benefit rate (CBR) of 20 cases in PCD group was 70.0% (14/20) and 85.0% (17/20), respectively; among 20 cases, there were 5 cases of complete response (CR), 4 cases of very good partial remission (VGPR), 5 cases of partial remission (PR), 3 cases of minimal remission (MR), 2 cases of stable disease (SD), 1 case of the progression of the disease (PD). ORR and CBR of 29 cases in the control group was 41.4% (12/29) and 65.5% (19/29), respectively; among 29 cases, there were 2 cases of CR, 3 cases of VGPR, 7 cases of PR, 7 cases of MR, 5 cases of SD, 5 cases of PD. There was a statistically significant difference in ORR of both group ( χ2 = 3.89, P = 0.048), while the difference in CBR of both group was not statistically significant ( χ2 = 2.30, P = 0.129). There were 2 patients with renal impairment achieving CR in PCD group and 1 patient with renal impairment achieving CR in the control group ( P = 0.152); 1 genetically high-risk patient achieved CR in PCD group and none of patients in the control group achieved CR, and the difference was statistically significant ( P>0.05). The common hematological adverse effects of two groups were anemia, neutropenia, thrombocytopenia; the common non-hematological adverse effects were malaise, infection and fatigue, and the differences were statistically significant (all P>0.05). The incidence of grade 3-4 infection was 25.0% (5/20) in PCD group and the disease was under the control after anti-infective therapy, and the incidence of grade 3-4 infection was 24.1% (7/29) in the control group; and the difference was not statistically significant ( P > 0.05). Conclusions:PCD regimen has good clinical efficacy and safety in treatment of relapsed/refractory MM.
ABSTRACT
Objective:To investigate the early efficacy and safety of pomalidomide-based regimen in relapsed/refractory multiple myeloma (MM) in the real world.Methods:The clinical data of 15 patients with relapsed/refractory MM treated with pomalidomide-based regimen who were admitted to Gansu Provincial Hospital from January 2021 to July 2021 were retrospectively analyzed, and the early efficacy and safety were also evaluated.Results:There were 8 males and 7 females, and the median age of onset of 15 patients was 60 years (43-83 years); the median time for the diagnosis of relapse and refractory was 15 months (4-84 months). All 15 patients previously received bortezomib-based treatment regimens, 9 patients previously received lenalidomide treatment, and 7 cases received autologous hematopoietic stem cell transplantation. All patients received pomalidomide-based regimen combined with two-drug or three-drug regimen (pomalidomide combined with bortezomib,daratumumab,bendamustine, dexamethasone, cyclophosphamide or lenalidomide). The median treatment cycle was 2 cycles (2-4 cycles). After 2 cycles of treatment, the therapeutic efficacy was evaluated; the overall response rate was 73% (11/15), including 3 cases of complete remission, 3 cases of very good partial remission, and 5 cases of partial remission. Hematological toxicity occurred in 9 patients, of which 5 cases had grade 3-4 hematological toxicity, 4 cases had grade 1-2 hematological toxicity, and other adverse reactions were mild and tolerable.Conclusion:Pomalidomide-based regimen is effective and safe for relapsed/refractory MM patients.
ABSTRACT
Multiple myeloma (MM), ranking the second most common malignancy in the blood system, is a heterogeneous disease characterized by clonal proliferation of plasma cells producing immunoglobulin. Due to the wide use of new drugs, including proteinase inhibitor (PI), immune modulators (IMiD) and monoclonal antibodies, great progress has been made in the treatment of MM, but almost all patients eventually develop drug resistance. Pomalidomide is the third generation of IMiD and a very well tolerated regimen for relapsed/refractory MM. This paper summarizes the combined therapy based on pomalidomide to provide the theoretical basis for a better clinical application of pomalidomide.
ABSTRACT
Thalidomide and the derivatives, lenalidomide and pomalidomide, are the most potent teratogenic medicines. Thalidomide Education and Risk Management System （TERMS®）and RevMate® for lenalidomide and pomalidomide have been operated with a goal of no exposed embryo to the drugs. The TERMS®and the RevMate®, a centralized management system, were revised in 2016 according to a request by a patient group. After the revision, the patient self-check sheet on adherence to conception prevention is primarily confirmed by his/her doctor, and the content of the completed sheet is sent to the management center in the pharmaceutical company after dispensing of the drug. The points for evaluation of the revised system will be as follows. (1) Has an appropriate procedure in accordance with the revised system been established in respective hospitals? (2) The rate of non-compliance with the procedure by the doctors or pharmacists, (3) Effect on awareness and behavior of the patients. Questionnaire studies of the patients, doctors, and pharmacists have been performed by the third-party committees.
ABSTRACT
<p>Thalidomide and the derivatives, lenalidomide and pomalidomide, are the most potent teratogenic medicines. Thalidomide Education and Risk Management System （TERMS<sup>®</sup>）and RevMate<sup>®</sup> for lenalidomide and pomalidomide have been operated with a goal of no exposed embryo to the drugs. The TERMS<sup>®</sup>and the RevMate<sup>®</sup>, a centralized management system, were revised in 2016 according to a request by a patient group. After the revision, the patient self-check sheet on adherence to conception prevention is primarily confirmed by his/her doctor, and the content of the completed sheet is sent to the management center in the pharmaceutical company after dispensing of the drug. The points for evaluation of the revised system will be as follows. (1) Has an appropriate procedure in accordance with the revised system been established in respective hospitals? (2) The rate of non-compliance with the procedure by the doctors or pharmacists, (3) Effect on awareness and behavior of the patients. Questionnaire studies of the patients, doctors, and pharmacists have been performed by the third-party committees.</p><p></p>
ABSTRACT
Pomalidomide,which represents a new generation of immunomodulatory drugs (IMiD),has brought a major shift in therapeutic paradigm in treating relapsed and refractory multiple myeloma (RRMM).Considering its encouraging effectiveness,the U.S.Food and Drug Administration (FDA) approved its usage to treat patients who fail to respond to at least two prior therapies,including lenalidomide and bortezomib,and whose disease progressed within 60 days of the last treatment.This review summarizes the mechanisms of action and clinical activity of pomalidomide in treating RRMM.