Safe and prolonged survival with Long-term exposure to Pomalidomide in Relapsed/Refractory Myeloma - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Annals of Oncology Année : 2016

Safe and prolonged survival with Long-term exposure to Pomalidomide in Relapsed/Refractory Myeloma

B. Pégourié
  • Fonction : Auteur
D. Caillot
  • Fonction : Auteur
B. Arnulf
  • Fonction : Auteur
G. Marit
  • Fonction : Auteur
S. Brechiniac
  • Fonction : Auteur
P. Rodon
  • Fonction : Auteur
M. Wetterwald
  • Fonction : Auteur
B. Royer
  • Fonction : Auteur

Résumé

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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Dates et versions

hal-01263111 , version 1 (19-09-2016)

Identifiants

Citer

G. Fouquet, B. Pégourié, M. Macro, M. O. Petillon, L. Karlin, et al.. Safe and prolonged survival with Long-term exposure to Pomalidomide in Relapsed/Refractory Myeloma. Annals of Oncology, 2016, 27 (5), pp.902-907. ⟨10.1093/annonc/mdw017⟩. ⟨hal-01263111⟩
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