POMALIDOMIDE, CYCLOPHOSPHAMIDE AND DEXAMETHASONE IN RELAPSED/REFRACTORY MULTIPLE MYELOMA PATIENTS IN A REAL LIFE SETTING: A SINGLE CENTER RETROSPECTIVE STUDY
Author(s): ,
Sabrina Trudel
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Benoît Tessoulin
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Maxime Jullien
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Nicolas Blin
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Thomas Gastinne
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Béatrice Mahé
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Viviane Dubruille
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Antoine Bonnet
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Anne Lok
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Patrice Chevallier
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Pierre Peterlin
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Alice Garnier
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Thierry Guillaume
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Amandine Le Bourgeois
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Steven Le Gouill
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
,
Philippe Moreau
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
Cyrille Touzeau
Affiliations:
Department of Hematology,Centre Hospitalier Universitaire,Nantes,France
EHA Library. Trudel S. Jun 14, 2019; 266450; PF651
Dr. Sabrina Trudel
Dr. Sabrina Trudel
Contributions
Abstract

Abstract: PF651

Type: Poster Presentation

Presentation during EHA24: On Friday, June 14, 2019 from 17:30 - 19:00

Location: Poster area

Background

Pomalidomide dexamethasone (Pd) is a standard of care for relapsed and refractory multiple myeloma (RRMM) patients who received at least two prior lines of therapy, including both lenalidomide and proteasome inhibitor (PI). In the phase 3 trial MM-003, patients randomized in the Pd arm achieved an overall response rate (ORR) of 31% and a median progression-free-survival (PFS) of 4 months. Similar results were confirmed in the STRATUS trial (MM-010). In order to improve these results, the triplet oral combination Pomalidomide Cyclophosphamide and Dexamethasone (PCD) has been investigated. To the best of our knowledge, we still need “real life” data evaluating the efficacy and safety of the triplet PCD combination in relapsed MM patients.

Aims

To evaluate efficacy and safety of PCD in unselected RRMM patients outside clinical trials.

Methods

All consecutive patients treated in our institution between January 2015 to July 2018 were included in this retrospective institutional review board approved analysis if they fulfilled the following criteria : (i) diagnosis of multiple myeloma according to International Myeloma Working Group  (IMWG) consensus criteria (ii) relapsed and/or refractory to at least two priors therapies, including lenalidomide and PI and (iii) treated with pomalidomide, cyclophosphamide and dexamethasone. Response to treatment was determined according to IMWG criteria. Progression-free-survival (PFS) and OS were estimated using the Kaplan-Meier method.

Results

49 consecutive patients were included. The median age was 66 years, including eight patients (16%) above 75 years. Nine (18%) patients had high-risk cytogenetic (t(4;14) or 17p deletion). The median number of prior therapies was 3 (range, 2-8) and all patients were previously exposed to proteasome inhibitors and lenalidomide. Thirty-nine (80%) patients were refractory to lenalidomide. Twenty-eight (57%) patients were refractory to PI. A double refractory status (lenalidomide and PI) was identified in 21 (43%) patients. The ORR was 76%, including 27% very good partial response or better. With a median follow-up of 16 months, the median PFS was 7.3 months and the median OS was not reached. Regarding safety, most frequent toxicity was hematologic, including 37% grade 3-4 cytopenias. Deep venous thrombosis were reported in 4% of patients. Nine patients (18%) discontinued therapy due to adverse event.

Conclusion

This real-life study demonstrated that PCD is therefore a manageable, cost-effective and oral triplet combination for unselected RRMM patients eligible to Pd.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Multiple myeloma

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