Abstract
Patients with refractory or relapsed multiple myeloma are considered to have a very poor prognosis, and new regimens are needed to improve this setting. Pomalidomide is a new immunomodulatory drug with high in vitro potency. Immunomodulatory drugs are hypothesized to act through multiple mechanisms. Here we performed a systemic analysis to evaluate pomalidomide-based chemotherapy (pomalidomide in combination with low-dose dexamethasone) as salvage treatment for patients with refractory and relapsed multiple myeloma. Clinical studies evaluating the efffectiveness of pomalidomide based regimens on response and safety for patients with refractory and relapsed multiple myeloma were identified using a predefined search strategy. Pooled response rate (RR) of treatment were calculated. For pomalidomide based regimens, 4 clinical studies which including 291 patients with refractory and relapsed multiple myeloma were considered eligible for inclusion. Systemic analysis suggested that, in all patients, pooled RR was 41.2% (120/291). Major adverse effects were hematologic toxicity, including grade 1 or 2 anemia, leucopenia and thrombocytopenia with pomalidomide based treatment. No treatment related death occurred. This pooled analysis suggests that pomalidomide in combination with low-dose dexamethasone is active with good tolerability in treating patients with refractory or relapsed multiple myeloma.
Highlights
Multiple myeloma (MM) is the most common primary tumor of bone marrow, and it is an incurable tumor that occurs in 4.8 to eight per 1,000,000 in the US
No treatment related death occurred. This pooled analysis suggests that pomalidomide in combination with low-dose dexamethasone is active with good tolerability in treating patients with refractory or relapsed multiple myeloma
Via steps of screening the title and reading the abstract, 4 studies were identified (Lacy et al, 2009; Lacy et al, 2010; Leleu et al, 2013; Richardson et al, 2014) when pomalidomide was used as a base in the treatment
Summary
Multiple myeloma (MM) is the most common primary tumor of bone marrow, and it is an incurable tumor that occurs in 4.8 to eight per 1,000,000 in the US. Treatment for MM has been greatly improved due to autologous stem cell transplantation and new drugs (thalidomide, lenalidomide, and bortezomib). These management increased rate of CR and subsequently extended survival in patients with MM (Genadieva-Stavric et al, 2014). Identification of novel cellular targets or signaling pathways regulating myeloma cell growth would improve clinical outcome and survival in MM patients refractory to chemotherapy. 2011; Rychak et al, 2011; Lopez-Girona et al, 2012; Rychak et al, 2013) On this background, we hypothesize that pomalidomide based treatment could be established as an optimal schedule for treating patients with MM
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