TY - JOUR
TI - Pomalidomide, bortezomib, and dexamethasone for multiple myeloma previously treated with lenalidomide (OPTIMISMM): outcomes by prior treatment at first relapse
AU - Dimopoulos, M.
AU - Weisel, K.
AU - Moreau, P.
AU - Anderson, L.D., Jr.
AU - White, D.
AU - San-Miguel, J.
AU - Sonneveld, P.
AU - Engelhardt, M.
AU - Jenner, M.
AU - Corso, A.
AU - Dürig, J.
AU - Pavic, M.
AU - Salomo, M.
AU - Casal, E.
AU - Srinivasan, S.
AU - Yu, X.
AU - Nguyen, T.V.
AU - Biyukov, T.
AU - Peluso, T.
AU - Richardson, P.
JO - Leukemia Research
PY - 2021
VL - 35
TODO - 6
SP - 1722-1731
PB - Springer Nature BV
SN - 0145-2126
TODO - 10.1038/s41375-020-01021-3
TODO - bortezomib;  dexamethasone;  lenalidomide;  pomalidomide;  antineoplastic agent;  bortezomib;  dexamethasone;  lenalidomide;  pomalidomide;  thalidomide, adult;  aged;  anemia;  Article;  cancer recurrence;  diarrhea;  drug dose reduction;  drug efficacy;  drug safety;  drug withdrawal;  fatigue;  febrile neutropenia;  female;  human;  hyperglycemia;  infection;  major clinical study;  male;  multiple cycle treatment;  multiple myeloma;  neutropenia;  pneumonia;  priority journal;  progression free survival;  rash;  sensory neuropathy;  stem cell transplantation;  thrombocytopenia;  treatment outcome;  treatment response;  very elderly;  clinical trial;  controlled study;  drug effect;  drug resistance;  follow up;  middle aged;  multicenter study;  multiple myeloma;  pathology;  phase 3 clinical trial;  prognosis;  randomized controlled trial;  salvage therapy;  survival rate;  tumor recurrence, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Bortezomib;  Dexamethasone;  Drug Resistance, Neoplasm;  Female;  Follow-Up Studies;  Humans;  Lenalidomide;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Recurrence, Local;  Prognosis;  Salvage Therapy;  Survival Rate;  Thalidomide
TODO - In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone (PVd) demonstrated superior efficacy vs bortezomib and dexamethasone (Vd) in patients with relapsed or refractory multiple myeloma previously treated with lenalidomide, including those refractory to lenalidomide. This analysis evaluated outcomes in patients at first relapse (N = 226) by lenalidomide-refractory status, prior bortezomib exposure, and prior stem cell transplant (SCT). Second-line PVd significantly improved PFS vs Vd in lenalidomide-refractory (17.8 vs 9.5 months; P = 0.0276) and lenalidomide-nonrefractory patients (22.0 vs 12.0 months; P = 0.0491), patients with prior bortezomib (17.8 vs 12.0 months; P = 0.0068), and patients with (22.0 vs 13.8 months; P = 0.0241) or without (16.5 vs 9.5 months; P = 0.0454) prior SCT. In patients without prior bortezomib, median PFS was 20.7 vs 9.5 months (P = 0.1055). Significant improvement in overall response rate was also observed with PVd vs Vd in lenalidomide-refractory (85.9% vs 50.8%; P < 0.001) and lenalidomide-nonrefractory (95.7% vs 60.0%; P < 0.001) patients, with similar results regardless of prior bortezomib or SCT. No new safety signals were observed. These data demonstrate the benefit of PVd at first relapse, including immediately after upfront lenalidomide treatment failure and other common first-line treatments. © 2020, The Author(s).
ER -