Clinical outcomes of pomalidomide-based and daratumumab-based therapies in patients with relapsed/refractory multiple myeloma: A real-world cohort study in China.

Publisher: John Wiley & Sons Ltd Country of Publication: United States NLM ID: 101595310 Publication Model: Print Cited Medium: Internet ISSN: 2045-7634 (Electronic) Linking ISSN: 20457634 NLM ISO Abbreviation: Cancer Med Subsets: MEDLINE

Original Publication: [Malden, MA] : John Wiley & Sons Ltd., c2012-

Thalidomide*/*analogs & derivatives; Multiple Myeloma*/drug therapy ; Multiple Myeloma*/mortality ; Multiple Myeloma*/pathology ; Thalidomide*/therapeutic use ; Antineoplastic Combined Chemotherapy Protocols*/therapeutic use ; Antibodies, Monoclonal*/therapeutic use; Humans ; Male ; Female ; Retrospective Studies ; Middle Aged ; Aged ; China ; Progression-Free Survival ; Aged, 80 and over ; Treatment Outcome ; Adult ; Neoplasm Recurrence, Local/drug therapy ; Drug Resistance, Neoplasm

Background: Comparative investigations evaluating the efficacy of pomalidomide-based (Pom-based) versus daratumumab-based (Dara-based) therapies in patients with relapsed/refractory multiple myeloma (RRMM) remain scarce, both in randomized controlled trials and real-world studies.
Methods: This retrospective cohort study included 140 RRMM patients treated with Pom-based or Dara-based or a combination of pomalidomide and daratumumab (DPd) regimens in a Chinese tertiary hospital between December 2018 and July 2023.
Results: The overall response rates (ORR) for Pom-based (n = 48), Dara-based (n = 68), and DPd (n = 24) groups were 57.8%, 84.6%, and 75.0%, respectively (p = 0.007). At data cutoff on August 1, 2023, the median progression-free survival (PFS) was 5.7 months (95% CI: 5.0-6.5) for the Pom-based group, 10.5 months (5.2-15.8) for the Dara-based group, and 6.7 months (4.0-9.3) for the DPd group (p = 0.056). Multivariate analysis identified treatment regimens (Dara-based vs. Pom-based, DPd vs. Pom-based) and Eastern Cooperative Oncology Group performance status (ECOG PS) as independent prognostic factors for PFS. In the subgroups of patients aged >65 years, with ECOG PS ≥2, lines of therapy ≥2, extramedullary disease or double-refractory disease (refractory to both lenalidomide and proteasome inhibitors), the superiority of Dara-based regimens over Pom-based regimens was not evident. A higher incidence of infections was observed in patients receiving Dara-based and DPd regimens (Pom-based 39.6% vs. Dara-based 64.7% vs. DPd 70.8%, p = 0.009).
Conclusions: In real-world settings, Pom-based, Dara-based, and DPd therapies exhibited favorable efficacy in patients with RRMM. Dara-based therapy yielded superior clinical response and PFS compared to Pom-based therapy.
(© 2024 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.)

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82270205 National Natural Science Foundation of China

Keywords: daratumumab; multiple myeloma; pomalidomide; recurrence; refractory

D2UX06XLB5 (pomalidomide)
4Z63YK6E0E (daratumumab)
4Z8R6ORS6L (Thalidomide)
0 (Antibodies, Monoclonal)

Date Created: 20240503 Date Completed: 20240503 Latest Revision: 20240505

20240505

PMC11066492

10.1002/cam4.7232

38698679