- In patients with relapsed/refractory (R/R) multiple myeloma (MM), the addition of cyclophosphamide (CY) to pomalidomide+dexamethasone (POM+DEX) enabled patients to overcome pomalidomide resistance and achieve an improved response.
Why this matters
- Prognosis is poor in patients with R/R MM.
- Phase 2 PERSPECTIVE study to investigate the addition of CY after an insufficient response to 3 cycles of POM+DEX in 60 patients with R/R MM.
- Patients had received a median of 3 prior treatment lines.
- Funding: Celgene Corp.
- Best response to cycles 1-3 of POM+DEX (n=59) vs best response after the addition of CY (n=36):
- Objective response rate: 18.6% vs 36.1%.
- Partial response: 15.2% vs 22.2%.
- Very good partial response: 3.4% vs 8.3%.
- Complete response: 0% vs 5.6%.
- Progressive disease: 18.6% vs 0%.
- Stable disease: 39.0% vs 33.3%.
- Minimal response: 20.3% vs 27.8%.
- Median PFS in the intent-to-treat population who received POM+DEX only, 6.4 months; median second PFS from initiation of CY in patients who received the triplet, 4.8 months.
- Most common hematologic and nonhematologic adverse events: neutropenia (66.6%) and pneumonia (16.7%), respectively.
- Protocol violations or other issues prevented 14 patients from receiving CY.