Long-term safety and efficacy of pomalidomide (POM) with or without low-dose dexamethasone (LoDEX) in relapsed and refractory multiple myeloma (RRMM) patients enrolled in the MM-002 phase II trial.

Authors

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David Samuel DiCapua Siegel

John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ

David Samuel DiCapua Siegel , Paul Gerard Guy Richardson , Ravi Vij , Craig C. Hofmeister , Rachid C. Baz , Sundar Jagannath , Christine Chen , Sagar Lonial , Andrzej J. Jakubowiak , Nizar J. Bahlis , Kevin W. Song , Andrew Belch , Noopur S. Raje , Chaim Shustik , Suzanne Lentzsch , Min Chen , Mohamed H. Zaki , Kenneth Carl Anderson

Organizations

John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, Dana-Farber Cancer Institute, Boston, MA, Washington University in St. Louis, St Louis, MO, Ohio State University Medical Center, Columbus, OH, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, Mount Sinai Medical Center, New York, NY, Princess Margaret Hospital, Toronto, ON, Canada, Emory University School of Medicine, Atlanta, GA, University of Chicago Medical Center, Chicago, IL, University of Calgary, Calgary, AB, Canada, Vancouver General Hospital, Vancouver, BC, Canada, University of Alberta, Edmonton, AB, Canada, Massachusetts General Hospital, Boston, MA, Royal Victoria Hospital; McGill University Health Centre, Montreal, QC, Canada, College of Physicians and Surgeons of Columbia University, New York, NY, Celgene Corporation, Summit, NJ

Research Funding

Pharmaceutical/Biotech Company

Background: MM-002 is a randomized, open-label, multicenter phase II trial evaluating the safety and efficacy of POM with or without LoDEX in advanced RRMM pts. Methods: Pts who had received ≥ 2 prior therapies, including lenalidomide (LEN) and bortezomib (BORT), and were refractory to their last treatment were randomized to POM+LoDEX (POM 4 mg/day, days 1–21 of a 28-day cycle; LoDEX 40 mg/week) or POM alone. End points included progression-free survival (PFS), response rate (according to EBMT criteria and investigator assessment), response duration, overall survival (OS), and safety. The efficacy outcomes are based on the intent-to-treat population (POM+LoDEX, n = 113; POM, n = 108). Results: The median number of prior therapies in each group was 5 (range 1–13). In the POM+LoDEX arm, 30 (27%) pts had high-risk cytogenetics, including del(17p13) and/or t(4p16/14q32). The overall response rate (≥ partial response) was 34% and 15% with POM+LoDEX and POM, respectively, with a median duration of 8.3 (95% CI: 5.8–10.1) and 8.8 (95% CI: 5.5–11.4) mos, respectively. At least minimal response was observed in 45% and 31% of pts, respectively. Median PFS was 4.6 (95% CI: 3.6–5.5) and 2.6 (95% CI: 1.9–2.8) mos with POM+LoDEX and POM, respectively, with a median follow-up of 16.0 and 12.2 mos. Median OS was 16.5 (95% CI: 12.4–18.5) and 13.6 (95% CI: 9.6–18.1) mos, respectively. The most common treatment emergent Gr 3/4 adverse events (AEs) reported in the safety population (n = 219) were neutropenia (44%), anemia (23%), thrombocytopenia (21%), and pneumonia (18%); there were no reports of Gr 3/4 peripheral neuropathy. The incidence of deep-vein thrombosis was low (2%). AEs were managed through dose reductions or interruptions, and supportive care with G-CSF (52%), RBC transfusions (47%), and platelet transfusions (17%). Discontinuations due to AEs were 10%. Conclusions: POM with or without LoDEX is clinically effective and generally well tolerated in RRMM pts who have received multiple prior treatments, including LEN and BORT. AEs were predictable and manageable. Updated data will be presented at the meeting. Clinical trial information: NCT00833833.

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Abstract Details

Meeting

2013 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Lymphoma and Plasma Cell Disorders

Track

Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT00833833

Citation

J Clin Oncol 31, 2013 (suppl; abstr 8588)

DOI

10.1200/jco.2013.31.15_suppl.8588

Abstract #

8588

Poster Bd #

54A

Abstract Disclosures