A Meta-Analysis of the Efficacy of Pomalidomide-Based Regimens for the Treatment of Relapsed/Refractory Multiple Myeloma After Lenalidomide Exposure.

The objective was to assess the benefit of pomalidomide-based combination regimens in patients with relapsed/refractory multiple myeloma (RRMM) previously treated with lenalidomide. A pooled estimate was obtained for efficacy outcomes including overall response rate (ORR), complete response (CR) rate, and progression-free survival (PFS) based on multiple trials conducted in this patient population. A literature search was conducted on March 22, 2022 for relevant trials published between January 1, 2016 and the search date. The search identified 12 eligible trials with publications dated between 2016 and 2021. The meta-analyses were conducted among the intention-to-treat (ITT) population (patients treated in all lines of therapy) and 2 subpopulations: 2L (only patients treated in the second line [2L]) and ≥2L (patients treated in the 2L and beyond). From the meta-analyses, ORR was 69.9% for ITT, 74.4% for ≥2L, and 87.2% for 2L. CR rate was 12.1% for ITT, 17.6% for ≥2L, and 29.7% for 2L. One-year PFS rates were 55.1% for ITT, 59.1% for ≥2L, and 74.0% for 2L. Two-year PFS rates were 29.3% for ITT, 36.0% for ≥2L, and 41.9% for 2L. Pomalidomide-based combination regimens were effective in patients with RRMM previously treated with lenalidomide and tended to be associated with better outcomes when used earlier in the treatment pathway. A drug class switch may not always be necessary when making treatment decisions for patients with RRMM for whom the benefits of lenalidomide have been exhausted, although this must be supported by comparative studies.

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Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure F.E.D. reported consulting fees from Janssen and participation on an advisory board for Amgen, Bristol Myers Squibb, Celgene, GlaxoSmithKline, Janssen, Oncopeptide, Sanofi, and Takeda. X.L. reported honoraria, research support, and consulting fees from AbbVie, Amgen, Bristol Myers Squibb, Gilead, GlaxoSmithKline, Harpoon Therapeutic, iTeos, Janssen, Merck, Novartis, Oncopeptides, Pfizer, Regeneron, Roche, Sanofi, and Takeda. P.V. in an employee of Bristol Myers Squibb. S.D. is an employee of and has equity ownership in Bristol Myers Squibb. P.L.N. is an employee of Amaris Consulting, contracted by Bristol Myers Squibb. K.W. reported research support from Amgen, Adaptive Biotech, AstraZeneca, Bristol Myers Squibb, BeiGene, Celgene, Janssen, GlaxoSmithKline, Sanofi, Stemline, and Takeda, honoraria from AbbVie, Amgen, Adaptive Biotech, AstraZeneca, Bristol Myers Squibb, BeiGene, Celgene, Janssen, GlaxoSmithKline, Karyopharm, Novartis, Oncopeptides, Pfizer, Roche, Sanofi, Stemline, and Takeda, and travel fees from Janssen, GlaxoSmithKline, and Sanofi.