The efficacy and safety of pomalidomide in patients with relapsed/refractory multiple myeloma

Advances in treatment optionsfor patients with multiple myeloma have madea significant impact on overall survival andhave helped to achieve the rates of response andduration of remission previously not unachievablewith standard chemotherapy-based approaches.These improvements are due, in a large part, tothe development of the novel agents, includingbortezomib, thalidomide, and lenalidomide, eachof which has substantial single-agent activity.Combinations of bortezomib, thalidomide, andlenalidomide with conventional agents or amongeach other have resulted in enhanced responserates and efficacy. However, when patients areunresponsive to immunomodulatory drugs andbortezomib, the prognosis becomes poor. Thisarticle reviews therapeutic efficacy and safety,dosage and administration, peculiar propertiesof the practical application of pomalidomide.Pomalidomide is an immunomodulatory drug thirdgeneration. In addition, this review presents theresults of base clinical trials testing pomalidomideand low-dose dexamethasone. Pomalidomide + low-dose dexamethasone is effective and well toleratedfor refractory or relapsed and refractory multiplemyeloma after bortezomib and lenalidomide failure.Problems of development of new treatment regimensbased on pomalidomide for relapsed and refractoryMM are also discussed. Pomalidomide + low-dose dexamethasone has been registered in Russiain 2015 for therapy of patients with MM relapsesand refractory MM, with a history of at least twocycles including lenalidomide and bortezomib, withdisease progressing after the latest course.