Adverse event (AE) management in patients (pts) with relapsed and refractory multiple myeloma (RRMM) taking pomalidomide (POM) plus low dose-dexamethasone (LoDEX): A pooled analysis from 3 clinical trials.

Authors

null

Philippe Moreau

CHU de Nantes, Hotel Dieu—HME, Nantes, France

Philippe Moreau , Meletios A. Dimopoulos , Paul G. Richardson , David Samuel DiCapua Siegel , Antonio Palumbo , Michele Cavo , Paolo Corradini , Katja Weisel , Michel Delforge , Peter O'Gorman , Kevin W. Song , Lars Axel Sternas , Teresa Peluso , Kevin Hong , Jennifer Herring , Xin Yu , Mohamed H. Zaki , Jesus San Miguel

Organizations

CHU de Nantes, Hotel Dieu—HME, Nantes, France, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Dana-Farber Cancer Institute, Boston, MA, John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, Department of Hematology, University of Torino, Torino, Italy, Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, University of Tubingen, Tubingen, Germany, University Hospital Leuven, Leuven, Belgium, Department of Haematology, Mater Misericordiae University Hospital; School of Medicine & Medical Science, University College Dublin, Dublin, Ireland, Vancouver General Hospital, Vancouver, BC, Canada, Celgene Corporation, Summit, NJ, Celgene International Sarl, Boudry, Switzerland, Clinica Universidad de Navarra, Pamplona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: Pts with RRMM who are heavily pretreated often have advanced disease and comorbidities, increasing their susceptibility to AEs. The management of AEs is important to ensure that pts remain on the therapy for as long as needed to receive a clinical benefit. In this analysis, safety data from 3 POM + LoDEX clinical trials (Richardson Blood 2014; San Miguel Lancet Oncol 2013; Dimopoulos ASH 2015) were pooled to better characterize the safety profile of POM + LoDEX and management of AEs. Methods: The 3 trials enrolled pts with ≥ 2 prior therapies, including lenalidomide and bortezomib, who had progressed on or within 60 days of their last therapy. Pts received POM 4 mg/day on days 1-21 of each 28-day cycle and LoDEX 40 mg (20 mg for those > 75 years of age) weekly until disease progression or unacceptable toxicity. Thromboprophylaxis was required. Grouped AE terms were used for analysis. Results: A total of 1088 pts from the 3 trials were included in the safety population. The most common grade 3/4 AEs were neutropenia (56%), infections (34%), anemia (32%), and thrombocytopenia (26%). AEs were managed by dose modifications and/or supportive care (Table). The rate of grade 3/4 venous thromboembolic events was low (2%). Peripheral neuropathy (PN) of any grade occurred in 17% of pts; 1% experienced grade 3/4 PN. AEs leading to POM dose reductions or interruptions occurred in 24% and 66% of pts, respectively. AEs leading to discontinuation of POM were infrequent (7%). Conclusions: In this large pooled safety analysis, POM + LoDEX showed an acceptable safety profile in pts with RRMM. AEs were manageable, and discontinuations due to AEs were uncommon. Clinical trial information: NCT00833833 (MM-002), NCT01311687 (MM-003), and NCT01712789 (MM-010)

POM + LoDEX
(N = 1088)
Dose management
    Median average POM dose (range), mg4.0 (1.6-4.2)
    ≥ 1 dose reduction, %24
    For neutropeniaa8
    For thrombocytopeniaa5
    For infectionsa4
Median time to AE onset (range), daysa
    Neutropenia (n = 693)20.0 (1.0-591.0)
    Thrombocytopenia (n = 393)15.0 (1.0-498.0)
    Infections (n = 748)41.5 (1.0-493.0)
Supportive care, %
    Anti-infective88
    Red blood cell transfusion45
    Granulocyte colony-stimulating factor17
    Platelet transfusion14

a Grouped AE terms.

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Abstract Details

Meeting

2016 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies—Plasma Cell Dyscrasia

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT00833833 (MM-002), NCT01311687 (MM-003), and NCT01712789 (MM-010)

Citation

J Clin Oncol 34, 2016 (suppl; abstr 8031)

DOI

10.1200/JCO.2016.34.15_suppl.8031

Abstract #

8031

Poster Bd #

296

Abstract Disclosures