Vnitr Lek 2016, 62(12):962-968

Pomalidomide in the treatment of multiple myeloma - own experience and overview of literature

Zdeněk Adam^1,*, Luděk Pour¹, Marta Krejčí¹, Eva Vetešníková¹, Viera Sandecká¹, Martin Štork¹, Zdeňka Čermáková^2,3, Eva Pourová⁴, Sabina Ševčíková⁵, Zdeněk Král¹, Jiří Mayer¹

¹ Interní hematologická a onkologická klinika LF MU a FN Brno, pracoviště Bohunice

² Oddělení klinické biochemie FN Brno, pracoviště Bohunice

³ Katedra laboratorních metod LF MU, Brno

⁴ Ordinace praktického lékaře pro dospělé, Pustiměř

⁵ Ústav patologické fyziologie LF MU, Brno

In the Czech Republic, pomalidomide is covered for patients with multiple myeloma (in combination with dexamethasone), in the treatment of patients with relapsed and refractory multiple myeloma, who underwent at least 2 previous treatment schedules including both lenalidomide and bortezomibe, with disease progression despite the last therapy (i.e. during the therapy or within 60 days of its end), for whom the only remaining alternative of treatment (apart from pomalidomide) is that using high-dose dexamethasone, and who are not indicated for myeloablative treatment followed by a transplant of stem cells. At our centre pomalidomide was used in 53 patients at a median age of 66 years based on this indication. Pomalidomide was administered in 1 daily dose over 21 days in 28-day cycles. Considering the risk of thromboembolism occurring in this therapy, all patients were administered a prophylactic dose of low-molecular-weight heparin. No patient achieved complete remission (Czech Republic), 5 patients (9.4 %) achieved very good partial remission (VGPR), partial remission (PR) was achieved by 16 (30.2 %) patients, a minimum therapeutic response (MR) was recorded for 6 (11.3 %) patients. The median number of administered cycles was 4.4 (1-22). 16 (28.5 %) patients received treatment for more than 6 months. The overall survival median cannot be evaluated so far due to a short follow-up period. Nonetheless it was possible to evaluate a median time interval to progression (TTP) for the patients, which amounted to 7.0 (3.8-8.2) months. These results are consistent with large registration studies where therapeutic response (at least PR) is reached by 1/3 of the patients and medians of therapeutic response range between 7-10 months. Pomalidomide is a medicine with very good tolerance which is efficient in patients with a progressing multiple myeloma.

Keywords: lenalidomide; multiple myeloma; pomalidomide; thalidomide

Received: July 20, 2016; Accepted: August 22, 2016; Published: December 1, 2016  Show citation