Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma.
In this report, a panel of European myeloma experts discuss the role of pomalidomide in the treatment of relapsed and refractory multiple myeloma (RRMM). Based on the available evidence, the combination of pomalidomide and low-dose dexamethasone is a well-tolerated and effective treatment option for patients with RRMM who have exhausted treatment with lenalidomide and bortezomib. The optimal starting dose of pomalidomide is 4 mg given on days 1-21 of each 28-day cycle, whereas dexamethasone is administered at a dose of 40 mg weekly (reduced to 20 mg for patients aged >75 years). The treatment should continue until evidence of disease progression or unacceptable toxicity. Dose-modification schemes have been established for patients who develop neutropenia, thrombocytopaenia and other grade 3-4 adverse events during pomalidomide therapy. Guidance on the prevention and management of infections and venous thromboembolism is provided, based on the available clinical evidence and the experience of panel members. The use of pomalidomide in special populations, such as patients with advanced age, renal impairment or unfavourable cytogenetic features, is also discussed.
University of Athens School of Medicine, Athens, Greece.
M A
MA
Dimopoulos
Service des Maladies du Sang, Hôpital Huriez, CHRU Lille, Lille, France.
X
X
Leleu
Divisione di Ematologia dell'Università di Torino, Azienda Ospedaliera S Giovanni Battista, Turin, Italy.
A
A
Palumbo
Service d'Hematologie, CHU, Nantes, France.
P
P
Moreau
University Hospital Leuven, Leuven, Belgium.
M
M
Delforge
Seràgnoli Institute of Hematology, Bologna University School of Medicine, Bologna, Italy.
M
M
Cavo
1st Department of Internal Medicine, Center for Oncology and Hematology, Wilhelminenhospital, Vienna, Austria.
H
H
Ludwig
Institute of Cancer Research, Royal Marsden Hospital, London, UK.
G J
GJ
Morgan
Institute of Cancer Research, Royal Marsden Hospital, London, UK.
F E
FE
Davies
Department of Hematology, University Hospital Rotterdam, Rotterdam, The Netherlands.
P
P
Sonneveld
Department of Haemato-oncology, King's College Hospital and King's College London, London, UK.
S A
SA
Schey
Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands.
S
S
Zweegman
Department of Hematology, Skåne University Hospital, Lund University, Lund, Sweden.
M
M
Hansson
University of Tuebingen, Tuebingen, Germany.
K
K
Weisel
Hospital Universitario de Salamanca, CIC, IBMCC (USAL-CSIC), Salamanca, Spain.
M V
MV
Mateos
Service des Maladies du Sang, Hôpital Huriez, CHRU Lille, Lille, France.
T
T
Facon
Clinica Universidad de Navarra, Centro Investigaciones Medicas Aplicada (CIMA), Pamplona, Spain.
J F S
JF
Miguel
D000367:Age Factors; D002986:Clinical Trials as Topic; D003907:Dexamethasone / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007239:Infections / Q000139:chemically induced; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology; D009503:Neutropenia / Q000139:chemically induced; D010523:Peripheral Nervous System Diseases / Q000139:chemically induced; D011788:Quality of Life; D013792:Thalidomide / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D054556:Venous Thromboembolism / Q000139:chemically induced
D007155:Immunologic Factors; D013792:Thalidomide; D003907:Dexamethasone; C467566:pomalidomide