Pomalidomide, Bortezomib, and Dexamethasone in Lenalidomide-Pretreated Multiple Myeloma : A Subanalysis of OPTIMISMM by Frailty and Bortezomib Dose Adjustment
Oriol, Albert (Institut Germans Trias i Pujol. Institut de Recerca contra la Leucèmia Josep Carreras)
Dimopoulos, Meletios (National and Kapodistrian University)
Schjesvold, Fredrik (University of Oslo)
Beksac, Meral (Ankara Üniversitesi Tip Fakültes)
Facon, Thierry (Hôpital Claude Huriez CHU de Lille)
Dhanasiri, Sujith (Celgene International Sàrl. a Bristol-Myers Squibb Company (Suïssa))
Guo, Shien (Evidera)
Mu, Yutian (Evidera)
Hong, Kevin (Bristol Myers Squibb)
Gentili, Christian (Bristol Myers Squibb)
Galli, Mónica (ASST Papa Giovanni XXIII)
Yagci, Munci (Gazi University)
Larocca, Alessandra (University of Torino)
Richardson, Paul (Dana-Farber Cancer Institute (Estats Units d'Amèrica))
Weisel, Katja (University Medical Center Hamburg-Eppendorf (Alemanya))

Date:	2023
Abstract:	Introduction: A proportion of patients with multiple myeloma (MM) are older and/or have comorbidities, requiring dose adjustments. Data from OPTIMISMM (NCT01734928) supported the use of pomalidomide, bortezomib, and dexamethasone (PVd) for treating relapsed/refractory MM. This subanalysis of OPTIMISMM assessed outcome by frailty and/or bortezomib dose adjustment. Methods: Patient frailty (nonfrail vs. frail) was classified using age, Charlson Comorbidity Index, and Eastern Cooperative Oncology Group performance status. Data from patients requiring a bortezomib dose reduction, interruption, and/or withdrawal during PVd treatment were assessed. Results: Among 559 patients, 93 of 281 (33. 1%) and 93 of 278 (33. 5%) patients who received PVd and bortezomib and dexamethasone (Vd), respectively, were frail. Overall response rate (ORR) and median progression-free survival (PFS) were higher in nonfrail vs. frail with PVd treatment (ORR, 82. 8% vs. 79. 6%; PFS, 14. 7 vs. 9. 7 months); significantly higher than with Vd regardless of frailty. Grade ≥ 3 treatment-emergent adverse events (TEAEs) were higher with PVd vs. Vd, regardless of frailty. Discontinuations of PVd were lower in nonfrail vs. frail patients (19. 2% vs. 30. 1%); the median duration of treatment was similar (DoT; 8. 8 vs. 8. 9 months, respectively). Patients who received PVd with a bortezomib dose adjustment (n = 240) had a longer median DoT (9. 3 vs. 4. 5 months) and PFS (12. 1 vs. 8. 4 months) vs. those without. Conclusion: Frail patients treated with PVd demonstrated a higher ORR and a longer PFS and DoT vs. Vd, despite a higher frequency of grade ≥ 3 TEAEs leading to pomalidomide, bortezomib, and/or dexamethasone discontinuation. Therefore, PVd treatment may improve patient outcomes, regardless of frailty.
Note:	The study was supported by Celgene, a Bristol-Myers Squibb company. All the authors contributed to and approved the manuscript. Professional medical writing support for this manuscript was provided by Joels Wilson-Nieuwenhuis, PhD, of Caudex, a division of IPG Health Medical Communications, funded by Bristol Myers Squibb.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Charlson Comorbidity Index ; Dose modifications ; ECOG PS ; Immunomodulatory agent ; Relapsed/refractory ; Multiple myeloma
Published in:	Clinical Lymphoma, Myeloma & Leukemia, 2023 , ISSN 2152-2669

DOI: 10.1016/j.clml.2023.10.009

16 p, 1.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP) > Josep Carreras Leukaemia Research Institute
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