Pomalidomide, bortezomib, and dexamethasone for multiple myeloma previously treated with lenalidomide (OPTIMISMM): outcomes by prior treatment at first relapse

In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone (PVd) demonstrated superior efficacy vs bortezomib and dexamethasone (Vd) in patients with relapsed or refractory multiple myeloma previously treated with lenalidomide, including those refractory to lenalidomide. This analys...

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Bibliographic Details
Published in:Leukemia 2021-06, Vol.35 (6), p.1722-1731
Main Authors: Dimopoulos, Meletios, Weisel, Katja, Moreau, Philippe, Anderson, Larry D., White, Darrell, San-Miguel, Jesus, Sonneveld, Pieter, Engelhardt, Monika, Jenner, Matthew, Corso, Alessandro, Dürig, Jan, Pavic, Michel, Salomo, Morten, Casal, Eva, Srinivasan, Shankar, Yu, Xin, Nguyen, Tuong Vi, Biyukov, Tsvetan, Peluso, Teresa, Richardson, Paul
Format: Article
Language:English
Subjects:
692/308/2779/777
692/699/67/1990/804
Bortezomib
Cancer Research
Comparative analysis
Critical Care Medicine
Development and progression
Dexamethasone
Drug therapy
Hematology
Immunotherapy
Inhibitor drugs
Intensive
Internal Medicine
Medicine
Medicine & Public Health
Multiple myeloma
Oncology
Stem cells
Steroids
Targeted cancer therapy
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Summary:In the phase 3 OPTIMISMM trial, pomalidomide, bortezomib, and dexamethasone (PVd) demonstrated superior efficacy vs bortezomib and dexamethasone (Vd) in patients with relapsed or refractory multiple myeloma previously treated with lenalidomide, including those refractory to lenalidomide. This analysis evaluated outcomes in patients at first relapse ( N  = 226) by lenalidomide-refractory status, prior bortezomib exposure, and prior stem cell transplant (SCT). Second-line PVd significantly improved PFS vs Vd in lenalidomide-refractory (17.8 vs 9.5 months; P  = 0.0276) and lenalidomide-nonrefractory patients (22.0 vs 12.0 months; P  = 0.0491), patients with prior bortezomib (17.8 vs 12.0 months; P  = 0.0068), and patients with (22.0 vs 13.8 months; P  = 0.0241) or without (16.5 vs 9.5 months; P  = 0.0454) prior SCT. In patients without prior bortezomib, median PFS was 20.7 vs 9.5 months ( P  = 0.1055). Significant improvement in overall response rate was also observed with PVd vs Vd in lenalidomide-refractory (85.9% vs 50.8%; P  
ISSN:0887-6924
1476-5551
DOI:10.1038/s41375-020-01021-3