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Pomalidomide-Based Triplets Improve Responses in Relapsed/Refractory Multiple Myeloma

Peter Voorhees, MD
Published Online:8:39 PM, Tue August 13, 2019


Peter Voorhees, MD, a myeloma specialist at Levine Cancer Institute, discusses the latest data for the use of pomalidomide (Pomalyst)-containing regimens for the treatment of patients with relapsed/refractory multiple myeloma. He highlights data from 2 randomized clinical trials that demonstrated an improvement in responses with pomalidomide-based triplets.

There have been several randomized clinical trials that have demonstrated superiority of pomalidomide-based combinations, Voorhees says. The phase II ELOQUENT-3 trial, in particular, looked at the combination of pomalidomide plus dexamethasone with or without elotuzumab (Empliciti). Results showed that patients had a higher likelihood of responding to the 3-drug regimen as compared with the 2-drug combination, and the depth of response also improved with the addition of elotuzumab. This translated to a significant improvement in median progression-free survival (PFS).

These phase II data led to the FDA approval of elotuzumab in combination with pomalidomide and low-dose dexamethasonefor the treatment of patients with relapsed/refractory multiple myeloma who have received at least 2 prior lines of therapies.

In the randomized phase III ICARIA-MM trial, presented at the 2019 ASCO Annual Meeting, the triplet regimen of pomalidomide, dexamethasone, and isatuximab also led to similar findingsin patients with relapsed/refractory disease. Patients had a higher likelihood of responding to the 3-drug regimen as compared with the pomalidomide/dexamethasone combination, while there was also a higher response rate and significantly improvement in PFS.
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