Pomalidomide in the treatment of multiple myeloma: design, development and place in therapy

Rafael Ríos-Tamayo, Agustín Martín-García, Carolina Alarcón-Payer, Dolores Sánchez-Rodríguez, Ana María Del Valle Díaz de la Guardia, Carlos Gustavo García Collado, Alberto Jiménez Morales, Manuel Jurado Chacón, José Cabeza Barrera, Rafael Ríos-Tamayo, Agustín Martín-García, Carolina Alarcón-Payer, Dolores Sánchez-Rodríguez, Ana María Del Valle Díaz de la Guardia, Carlos Gustavo García Collado, Alberto Jiménez Morales, Manuel Jurado Chacón, José Cabeza Barrera

Abstract

Multiple myeloma is a very heterogeneous disease with variable survival. Despite recent progress and the widespread use of new agents, patients with relapsed and refractory disease have a poor outcome. Immunomodulatory drugs play a key role in both the front-line and the relapsed/refractory setting. The combination of pomalidomide (POM) and dexamethasone is safe and effective in relapsed and refractory patients, even in those with high-risk cytogenetic features. Furthermore, it can be used in most patients without the need to adjust according to the degree of renal failure. In order to further improve the results, POM-based triplet therapies are currently used. This article highlights the most relevant issues of POM and POM-based combinations in the relapsed/refractory multiple myeloma setting, from a pharmacological and clinical point of view.

Keywords: dexamethasone; multiple myeloma; pomalidomide; triplet therapy.

Conflict of interest statement

Disclosure R Ríos-Tamayo has received honoraria and participated in advisory boards for Amgen, Janssen, Celgene, Takeda, and Bristol-Myers Squibb. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Chemical structure of immunomodulatory drugs. Note: Common structural features are shown in black.
Figure 2
Figure 2
Schematic representation of the mechanism of action of POM. Abbreviations: POM, pomalidomide; NK, natural killer.
Figure 3
Figure 3
Number of POM-based clinical trials by trimesters. Note: *Data registered until February 27th 2017. Abbreviation: POM, pomalidomide.

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