Abstract
Even in the era of novel immunotherapies for multiple myeloma (MM), treatment of late stage relapsed/refractory(RR) patients remains challenging. Especially in patients being resistant to two classes of IMiDs, and two classes of proteasome inhibitors, and to the monoclonal antibody daratumumab (referred to as penta-refractory), effective treatments are highly warranted. Here, we report on our experience with the five-drug combination pomalidomide, bortezomib, doxorubicin, dexamethasone, and daratumumab (Pom-PAD-Dara).
Highlights
Despite a growing number of approved drugs, disease relapse is frequently observed in multiple myeloma (MM) and the treatment of late stage relapsed/refractory (RR) disease remains challenging
Dimopoulos et al reported that patients with lenalidomide refractory RRMM were treated with elotuzumab plus pomalidomide and dexamethasone and achieved an overall response rate (ORR) of 53%
In a study by Chari et al (EQUULEUS trial), an ORR of 60% was observed in patients with RRMM that were treated with daratumumab plus pomalidomide and dexamethasone
Summary
Despite a growing number of approved drugs, disease relapse is frequently observed in multiple myeloma (MM) and the treatment of late stage relapsed/refractory (RR) disease remains challenging. Novel immunotherapies, such as antibody-drug-conjugates, bispecific antibodies, and chimeric antigen receptor T-cell, may change our future treatment strategies. For patients progressing on standard therapy, further treatment options using already approved drugs are urgently needed, as salvage or bridging therapy. This is in particular true for patients that progressed on lenalidomide, pomalidomide, bortezomib, carfilzomib, and daratumumab, the so called “penta-refractory” disease.
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