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Safe and prolonged survival with long-term exposure to pomalidomide in relapsed/refractory myeloma.
Fouquet, G; Pegourie, B; Macro, M; Petillon, M O; Karlin, L; Caillot, D; Roussel, M; Arnulf, B; Mathiot, C; Marit, G; Kolb, B; Stoppa, A M; Brechiniac, S; Richez, V; Rodon, P; Banos, A; Wetterwald, M; Garderet, L; Royer, B; Hulin, C; Benbouker, L; Decaux, O; Escoffre-Barbe, M; Fermand, J P; Attal, M; Avet-Loiseau, H; Moreau, P; Facon, T; Leleu, X.
Affiliation
  • Fouquet G; Department of Blood Diseases, Hôpital Huriez, CHRU Lille, Lille.
  • Pegourie B; Department of Hematology, Hôpital A.Michallon, CHU Grenoble, Grenoble.
  • Macro M; Department of Hematology, Hôpital Côte de Nacre, CHU Caen, Caen.
  • Petillon MO; Department of Blood Diseases, Hôpital Huriez, CHRU Lille, Lille.
  • Karlin L; Department of Hematology, Centre Hospitalier Lyon-Sud, Lyon.
  • Caillot D; Department of Hematology, CHU de Dijon, Dijon.
  • Roussel M; Department of Hematology, CHU de Toulouse, Toulouse.
  • Arnulf B; Department of Hematology, Hôpital Saint Louis, APHP, Paris.
  • Mathiot C; Intergroupe Francophone du Myélome (IFM).
  • Marit G; Department of Hematology and Cell Therapy Service, CHU de Bordeaux, Pessac, France.
  • Kolb B; Department of Hematology, Hôpital Robert Debré, CHU Reims, Reims.
  • Stoppa AM; Department of Hematology, Institut Paoli Calmettes, Marseille.
  • Brechiniac S; Department of Hematology, CHU Avicennes, APHP, Paris.
  • Richez V; Department of Hematology, CHU Nice, Nice.
  • Rodon P; Department of Hematology, CH de Périgueux, Périgueux.
  • Banos A; Department of Hematology, CH de la Côte Basque, Bayonne.
  • Wetterwald M; Department of Hematology, CH de Dunkerque, Dunkerque.
  • Garderet L; Department of Hematology, CHU St-Antoine, Paris.
  • Royer B; Department of Hematology, Hôpital Sud, CHU Amiens, Amiens.
  • Hulin C; Department of Hematology, Hôpital de Nancy, Nancy.
  • Benbouker L; Department of Hematology, Hôpital de Tours, Tours.
  • Decaux O; Department of Hematology, CHU Rennes, Rennes.
  • Escoffre-Barbe M; Department of Hematology, CHU Rennes, Rennes.
  • Fermand JP; Department of Hematology, Hôpital Saint Louis, APHP, Paris.
  • Attal M; Department of Hematology, CHU de Toulouse, Toulouse.
  • Avet-Loiseau H; Department of Hematology, CHU de Toulouse, Toulouse.
  • Moreau P; Department of Hematology, CHU Nantes, Nantes.
  • Facon T; Department of Blood Diseases, Hôpital Huriez, CHRU Lille, Lille.
  • Leleu X; Department of Hematology, CHU Poitiers, Poitiers xavier.leleu@chu-poitiers.fr.
Ann Oncol ; 27(5): 902-7, 2016 05.
Article in En | MEDLINE | ID: mdl-26787238
BACKGROUND: The IFM2009-02 trial studied pomalidomide (4 mg daily, 21/28 versus 28/28) and dexamethasone in very advanced relapsed or refractory multiple myeloma (RRMM). We observed that 40% of patients had a prolonged progression-free survival (PFS) and subsequently overall survival (OS). We sought to analyze the characteristics of these patients and study the effect of long exposure to pomalidomide. DESIGN: We separated the studied population into two groups: 3 months to 1 year (<1 year) and more than 1 year (≥1 year) of treatment with pomalidomide and dexamethasone based on clinical judgment and historical control studies. We then analyzed the characteristics of patients according to duration of treatment. RESULTS: The overall response rate (ORR) for the <1-year group was 43%, the median PFS 4.6 months [95% confidence interval (95% CI) 3.8-6.4] with only 6% at 12 months, and the median OS was 15 months (11.7-20.3) and 40% at 18 months. For the ≥1-year group, the response rate and survival were strikingly different, ORR at 83%, median PFS 20.7 months (14.7-35.4), median OS not reached, and 91% at 18 months. CONCLUSION: Pomalidomide and dexamethasone favored prolonged and safe exposure to treatment in 40% of heavily treated and end-stage RRMM, a paradigm shift in the natural history of RRMM characterized with a succession of shorter disease-free intervals and ultimately shorter survival. Although an optimization of pomalidomide-dexamethasone regimen is warranted in advanced RRMM, we claim that pomalidomide has proven once more to change the natural history of myeloma in this series, which should be confirmed in a larger study.
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Full text: 1 Database: MEDLINE Main subject: Thalidomide / Drug Resistance, Neoplasm / Multiple Myeloma / Neoplasm Recurrence, Local Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Ann Oncol Journal subject: NEOPLASIAS Year: 2016 Type: Article

Full text: 1 Database: MEDLINE Main subject: Thalidomide / Drug Resistance, Neoplasm / Multiple Myeloma / Neoplasm Recurrence, Local Limits: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Language: En Journal: Ann Oncol Journal subject: NEOPLASIAS Year: 2016 Type: Article