Pomalidomide (CC4047) plus low dose dexamethasone (Pom/dex) is active and well tolerated in lenalidomide refractory multiple myeloma (MM)
Open accessAbstract
Patients with multiple myeloma progressing on current therapies have limited treatment options. Pomalidomide (CC4047), an immunomodulatory drug, has significant activity in relapsed myeloma and previous studies suggest activity in lenalidomide refractory disease. To better define its efficacy in this group, we treated a cohort of lenalidomide refractory patients. Pomalidomide was given orally (2 mg) daily, continuously in 28-day cycles along with dexamethasone (40 mg) given weekly. Responses were assessed by the International Myeloma Working Group Criteria. Thirty-four patients were enrolled. The best response was very good partial response in 3 (9%), partial response (PR) in 8 (23%), best responses (MR) in 5 (15%), stable disease in 12 (35%) and progressive disease in 6 (18%), for an overall response rate of 47%. Of the 14 patients that were considered high risk, 8 (57%) had responses including 4 PR and 4 MR. The median time to response was 2 months and response duration was 9.1 months, respectively. The median overall survival was 13.9 months. Toxicity was primarily hematologic, with grade 3 or 4 toxicity seen in 18 patients (53%) consisting of anemia (12%), thrombocytopenia (9%) and neutropenia (26%). The combination of pomalidomide and dexamethasone (Pom/dex) is highly active and well tolerated in patients with lenalidomide-refractory myeloma.
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Pomalidomide has significant activity in relapsed refractory multiple myeloma, even in patients who are failing lenalidomide.
“It has significant activity in relapsed refractory multiple myeloma, even in patients failing lenalidomide.169,170”
From Multiple myeloma: 2024 update on diagnosis, risk-stratification, and management (2024) · cites this paper as [170]
Pomalidomide combined with dexamethasone provided an option for lenalidomide-refractory patients.
“Pomalidomide, also combined with dexamethasone (Pom/Dex), has since provided an option for lenalidomide-refractory patients (lacy et al. 2010).”
From From serendipity to strategy: molecular glue degraders in cancer therapeutics (2025) · cites this paper as lacy et al. 2010
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“Pomalidomide, also combined with dexamethasone (Pom/Dex), has since provided an option for lenalidomide-refractory patients (lacy et al. 2010). while iMiDs are crucial in treating multiple myeloma, resistance often arises from mutations in cRl4 cRBN or alterations in the iRF4/c-Myc signaling axis,…”
- Authors
- Lacy, M. Q., Hayman, S. R., Gertz, M. A., Short, K. D., Dispenzieri, A., Kumar, S., Greipp, P. R., Lust, J. A., Russell, S. J., Dingli, D., Zeldenrust, S., Fonseca, R., Bergsagel, P. L., Roy, V, Mikhael, J. R., Stewart, A. K., Laumann, K., Allred, J. B., Mandrekar, S. J., Rajkumar, S. V., & Buadi, F.
- Affiliations
- Mayo Clinic (US)
- Mayo Clinic in Arizona (US)
- Mayo Clinic in Florida (US)
- Corresponding author
- Lacy, M Q
- ORCID
- Venue
- Leukemia
- Published
- 2010-09-09
- Volume
- 24
- Issue
- 11
- Pages
- 1934-1939
- ISSN
- 0887-6924 (ISSN-L)
- 1476-5551
- PMC
- PMC2978257
- OpenAlex
- W1968654086
- Semantic Scholar
- d63f950fb2597b68ec1fd32d051563fbba5bc60a
- Cited by
- 197
- References
- 17
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 9 · 2021: 1 · 2020: 3 · 2019: 7 · 2018: 15 · 2017: 11 · 2016: 15 · 2015: 16 · 2014: 26 · 2013: 36 · 2012: 23
- FWCI
- 17.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Leukemia (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Mayo Clinic
- Celgene
- National Cancer Institute (R01CA133966, R01CA136671)
- Topics
- Health Sciences › Medicine › Hematology › Multiple Myeloma Research and Treatments
- Health Sciences › Medicine › Oncology › Bone health and treatments
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Protein Degradation and Inhibitors
- Keywords
- pomalidomide, dexamethasone, lenalidomide-refractory multiple myeloma, relapsed multiple myeloma, immunomodulators, combination chemotherapy, overall response rate, overall survival, hematologic toxicity, anemia, thrombocytopenia, neutropenia
- MeSH terms
- Adult, Aged, Antineoplastic Agents, Antineoplastic Combined Chemotherapy Protocols, Dexamethasone, Drug Tolerance, Female, Humans, Male, Middle Aged, Multiple Myeloma, Thalidomide, Survival Rate, Disease Progression, Risk Assessment
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