Good morning! I have neglected reporting about pomalidomide. This new, experimental, novel therapy agent continues to impress in a slow, deliberate way.
No negative surprises (so far!) that I can see. Very good responses in patients refractory to Velcade and Revlimid. Here is an example of an abstract provided by Celgene yesterday:
Abstract #863 – Pomalidomide Plus Low-Dose Dexamethasone in Myeloma Refractory to Both Bortezomib and Lenalidomide: Comparison of Two Dosing Strategies in Dual-Refractory Disease
In a Phase 2 study presented by Martha Lacy, M.D., of the Mayo Clinic, two different doses of pomalidomide (2 mg daily and 4 mg daily in 28-day cycles) with low dose dexamethasone 40 mg (days 1, 8, 15 and 22 of each 28-day cycle) were studied. Patients with disease refractory to both lenalidomide and bortezomib were enrolled in each cohort of this study. The median number of previous multiple myeloma treatments received was six in both arms. In addition more than 40% of patients in both arms had poor prognostic molecular markers.
Objective responses (minor response or better) were seen in 49% (17) and 40% (14) of patients in the 2 mg and 4 mg groups, respectively, with PR or better being observed in 26% (9) of patients in each group. The majority of patients remain in disease remission at time of reporting. Overall survival at six months was 78% (95% CI: 65-95) and 69% (95% CI: 53-89) for the 2 mg and 4 mg groups, respectively.
Overall, grade 3 or 4 haematological adverse events were seen in 49% and 66% of patients in the 2 mg and 4 mg groups, respectively, with the most common grade 3 and 4 adverse events being neutropenia, thrombocytopenia and anaemia. Cases of neuropathy possibly attributed to pomalidomide treatment were seen in 20% (7) and 29% (10) of patients in the 2 mg and 4 mg groups, respectively.
Good results so far! Nearly 50% of refractory patients, some high risk, responded.
Feel good and keep smiling! Pat