Pomalidomide-dexamethasone for treatment of soft-tissue plasmacytomas in patients with relapsed / refractory multiple myeloma.

Abstract

OBJECTIVE:

The presence of plasmacytomas (Ps) in patients with multiple myeloma (MM) is associated with a poor outcome, both in patients treated conventionally and in patients treated with novel agents. Two types of plasmacytomas have being recognized: paraskeletal plasmacytomas (PPs) and extramedullary plasmacytomas (EMPs), being the incidence of EMPs lower but with worse prognosis. Our aim has been to analyze the efficacy of the pomalidomide-dexamethasone combination in this patient profile.

METHOD:

In the present study, the efficacy of pomalidomide and dexamethasone in 21 patients from nine hospitals of Catalonia (Spain), with relapsed or refractory MM and Ps, was analyzed. For this purpose, we describe the evolution of paraprotein in serum and urine and the size of plasmacytomas during treatment with pomalidomide-dexamethasone.

RESULTS:

While 34% of the patients achieved a paraprotein response, only two patients with PPs (9%) responded (RC and PR). There were no responses among patients with EMPs. The median progression-free survival from the start of treatment with pomalidomide/dexamethasone was only 1.7 months and the median overall survival of 4.5 months.

CONCLUSION:

In conclusion, pomalidomide and dexamethasone has limited efficacy in patients with advanced MM and soft-tissue plasmacytomas.

• Authors: Raquel Jiménez-Segura, Miquel Granell, Mercè Gironella, Eugenia Abella, Antoni García-Guiñón, Albert Oriol, Elena Cabezudo, Victoria Clapés, Joan Alfons Soler, Lourdes Escoda, Jordi López-Pardo, Carlos Fernández de Larrea, Maria Teresa Cibeira, Natalia Tovar, Ignacio Isola, Joan Bladé, Laura Rosiñol, GEMMAC (Grup per l l'estudi del mieloma mútiple i l'amiloïdosi de Catalunya)
• Journal: European journal of haematology (Eur J Haematol) Vol. 102 Issue 5 Pg. 389-394 (May 2019) ISSN: 1600-0609 [Electronic] England
• PMID: 30719772 (Publication Type: Journal Article)
• Copyright: © 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Thalidomide
• Dexamethasone
• pomalidomide

Topics

• Adult
• Aged
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Dexamethasone (administration & dosage)
• Drug Resistance, Neoplasm
• Female
• Humans
• Male
• Middle Aged
• Multimodal Imaging
• Multiple Myeloma (complications, diagnosis)
• Neoplasm Recurrence, Local
• Plasmacytoma (complications, diagnosis, drug therapy)
• Soft Tissue Neoplasms (complications, diagnosis, drug therapy)
• Thalidomide (administration & dosage, analogs & derivatives)