Pomalidomide in Refractory Multiple Myeloma
Published Online: Friday, August 15, 2014
For High-Definition, ClickPomalidomide is a third-generation immunomodulatory drug approved by the FDA for multiple myeloma, specifically for patients who experience disease progression after treatment with at least 2 prior therapies including lenalidomide or bortezomib. Noopur Raje, MD, Sagar Lonial, and Ann McNeill, RN, APN, state that pomalidomide is a relatively well tolerated drug. Also, pomalidomide is available as a pill formulation, which has advantages for patients in terms of convenience, comment Raje and Lonial.
McNeill remarks that an adverse event that occurs in most patients is fatigue, which can be either related to the disease or a medication-related adverse event, and can be brought on by anemia, dehydration, or depression. McNeill also notes that thrombocytopenia is commonly seen with proteasome inhibitors and neutropenia with immunomodulatory drugs. Other common adverse events include diarrhea, constipation, and peripheral neuropathy.
Compared with older agents, the newer immunomodulatory drugs seem to have an improved toxicity profile, remarks Raje. She explains that whereas with higher doses of thalidomide, many patients experienced neuropathy and constipation, lenalidomide is associated with less neuropathy and constipation, and pomalidomide is generally well tolerated. McNeill comments that discontinuation of pomalidomide is usually due not due to intolerable toxicity but rather due to disease progression.
Neutropenia seems to be the most common hematologic toxicity that occurs with pomalidomide, states McNeill; however, the neutropenia is manageable. Patients are monitored frequently for blood counts, and the dose of pomalidomide may be adjusted if neutropenia persists. Patients are also monitored for neuropathy. Lonial notes that thrombosis prophylaxis is another consideration for patients on pomalidomide therapy.
View More From This Discussion
Online CME Activities
Most Popular Right Now
The content contained in this video is for general information purposes only. The viewer is encouraged to confirm the information presented with other sources. OncLiveTV Peer Exchange makes no representations or warranties of any kind about the completeness, accuracy, timeliness, reliability, or suitability of any of the information, including content or advertisements, contained in this video and expressly disclaims liability for any errors and omissions that may be presented in this video. OncLiveTV Peer Exchange reserves the right to alter or correct any error or omission in the information it provides in this video, without any obligations. OncLiveTV Peer Exchange further disclaims any and all liability for any direct, indirect, consequential, special, exemplary, or other damages arising from the use or misuse of any material or information presented in this video. The views expressed in this video are those of the panelists and do not necessarily reflect the opinion or policy of OncLiveTV Peer Exchange.