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

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  • Meletios Dimopoulos
  • Katja Weisel
  • Philippe Moreau
  • Larry D Anderson
  • Darrell White
  • Jesus San-Miguel
  • Pieter Sonneveld
  • Monika Engelhardt
  • Matthew Jenner
  • Alessandro Corso
  • Jan Dürig
  • Michel Pavic
  • Morten Salomo
  • Eva Casal
  • Shankar Srinivasan
  • Xin Yu
  • Tuong Vi Nguyen
  • Tsvetan Biyukov
  • Teresa Peluso
  • Paul Richardson
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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 < 0.001) and lenalidomide-nonrefractory (95.7% vs 60.0%; P < 0.001) patients, with similar results regardless of prior bortezomib or SCT. No new safety signals were observed. These data demonstrate the benefit of PVd at first relapse, including immediately after upfront lenalidomide treatment failure and other common first-line treatments.

Original languageEnglish
JournalLeukemia
Volume35
Issue number6
Pages (from-to)1722-1731
Number of pages10
ISSN0887-6924
DOIs
Publication statusPublished - Jun 2021

ID: 62110222