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泊马度胺、环磷酰胺和地塞米松治疗复发/难治性多发性骨髓瘤:Pethema-GEM 经验的真实世界分析。

Pomalidomide, Cyclophosphamide, and Dexamethasone for the Treatment of Relapsed/Refractory Multiple Myeloma: Real-World Analysis of the Pethema-GEM Experience.

机构信息

Department of Hematology, Clínica Universidad de Navarra, Pamplona, Spain.

Department of Hematology, Hospital Donostia, San Sebastian, Spain.

出版信息

Clin Lymphoma Myeloma Leuk. 2021 Jun;21(6):413-420. doi: 10.1016/j.clml.2021.02.004. Epub 2021 Feb 16.

DOI:
10.1016/j.clml.2021.02.004
PMID:33741302
Abstract

INTRODUCTION

Treatment of relapsed/refractory multiple myeloma (RRMM) is highly challenging, especially for patients with disease refractory to initial therapy, and in particular for disease developing refractoriness to lenalidomide. Indeed, with currently approved treatments, median progression-free survival (PFS) in the lenalidomide-refractory setting is less than 10 months, reflecting the difficulty in treating this patient population. Pomalidomide is a second-generation immunomodulatory drug that has shown activity in lenalidomide-refractory disease in the setting of different combinations.

PATIENTS AND METHODS

A real-world study was conducted by the Spanish Myeloma group in a cohort of patients with RRMM treated with pomalidomide, cyclophosphamide, and dexamethasone (PomCiDex). One hundred patients were treated with a median of 3 prior lines of therapy.

RESULTS

Overall response rate was 39%, with a clinical benefit rate of 93%. Median PFS was 7.6 months; median overall survival (OS) was 12.6 months. Median PFS and OS survival were consistent across the different subgroups analyzed. Prolonged PFS and OS were found in patients with responsive disease.

CONCLUSION

Our results compared favorably with those obtained with different pomalidomide-based combinations in a similar patient population. PomCiDex remains a manageable, cost-effective, and all-oral triplet combination for RRMM patients.

摘要

简介

复发性/难治性多发性骨髓瘤(RRMM)的治疗极具挑战性,尤其是对于初始治疗耐药的患者,尤其是对于对来那度胺产生耐药性的疾病。事实上,在目前批准的治疗方法中,来那度胺耐药患者的中位无进展生存期(PFS)不到 10 个月,反映出治疗这一患者群体的困难。泊马度胺是一种第二代免疫调节药物,在不同联合治疗中来那度胺耐药疾病中显示出活性。

患者和方法

西班牙骨髓瘤小组在接受泊马度胺、环磷酰胺和地塞米松(PomCiDex)治疗的 RRMM 患者队列中进行了一项真实世界研究。100 名患者接受了中位数为 3 线治疗。

结果

总体缓解率为 39%,临床获益率为 93%。中位 PFS 为 7.6 个月;中位总生存期(OS)为 12.6 个月。分析的不同亚组中,中位 PFS 和 OS 生存情况一致。有反应性疾病的患者 PFS 和 OS 延长。

结论

我们的结果与类似患者群体中使用不同泊马度胺为基础的联合治疗获得的结果相比具有优势。PomCiDex 仍然是 RRMM 患者一种易于管理、具有成本效益的三药口服联合方案。

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