Safety and tolerability of pomalidomide-based regimens (pomalidomide-carfilzomib-dexamethasone with or without cyclophosphamide) in relapsed/refractory multiple myeloma and severe renal dysfunction: a case series

Joshua Richter, Noa Biran, Narjust Duma, David H. Vesole, David Siegel

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Renal dysfunction negatively impacts outcomes in patients with multiple myeloma (MM). Few treatment options are currently available for patients with MM and comorbid renal dysfunction, and as they are generally excluded from clinical trials, data on the use of immunomodulatory drugs in this population are scarce. In this paper, we describe a case series of five women with MM and severe renal dysfunction or dialysis dependency who were refractory to both bortezomib and either lenalidomide or thalidomide and were treated with full-dose (4 mg) pomalidomide. As part of their treatment regimen, these patients also received carfilzomib and dexamethasone with or without cyclophosphamide. All five patients achieved at least a partial response to pomalidomide-based therapy, which was relatively well tolerated. Our findings suggest that pomalidomide may represent a valuable and tolerable treatment option for MM patients with severe renal impairment. The fact that pomalidomide is extensively metabolized prior to urinary excretion may explain the improved tolerability of pomalidomide versus lenalidomide in such patients.

Original languageEnglish
Pages (from-to)246-251
Number of pages6
JournalHematological Oncology
Volume35
Issue number2
DOIs
StatePublished - Jun 2017
Externally publishedYes

Keywords

  • immunotherapy
  • multiple myeloma
  • pomalidomide
  • renal dysfunction
  • salvage therapy

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