Real-world outcomes of pomalidomide therapy after lenalidomide induction in relapsed/refractory multiple myeloma

Aim: To demonstrate the efficacy of pomalidomide for relapsed/refractory multiple myeloma (RRMM) following treatment in real-world, community practice using retrospective database analysis. Materials & methods: US-based community oncologists identified patients with RRMM treated with or without pomalidomide following first-line lenalidomide. Disease response (≥ very good partial response) and progression-free survival were compared. Results: Disease response was 78.6 and 51.7% for pomalidomide (n = 126) and nonpomalidomide cohorts (n = 174), respectively (p < 0.0001). Multivariate adjusted odds of response were 4.5-times greater for pomalidomide cohort (p < 0.0001). Median progression-free survival was not reached for pomalidomide cohort and 16.7 months for nonpomalidomide cohort (log-rank p < 0.01). Conclusion: Following lenalidomide induction in RRMM, pomalidomide is an effective treatment.Plain language summary Treatment options have expanded in recent years for patients with relapsed/refractory multiple myeloma (RRMM) who received lenalidomide as their initial treatment and then either had a period of improvement before the disease worsened or did not respond to the medication at all. Pomalidomide is another MM treatment from the same drug class as lenalidomide. We analyzed the effect of a combination treatment containing pomalidomide versus a combination treatment without pomalidomide in patients with MM who had received routine initial treatment with lenalidomide. US-based community oncologists completed study forms to record patient characteristics and treatment response information. Results showed that patients who received pomalidomide in a combination treatment after initial lenalidomide treatment achieved higher rates of very good partial response or better and longer progression-free survival than those who did not. The results of this analysis suggest that switching to a different class of drugs following the initial treatment may not be warranted after first relapse and pomalidomide-containing combination treatments are a more effective treatment following lenalidomide for patients with RRMM.