Dr. Chari on PVd for Relapsed Patients With Multiple Myeloma

Ajai Chari, MD, associate professor of Medicine, Hematology and Medical Oncology, at Mount Sinai Hospital, discusses the use of pomalidomide (Pomalyst), bortezomib (Velcade), and dexamethasone (PVd) for relapsed patients with multiple myeloma.

At the 2018 ASCO Annual Meeting, Paul Richardson, MD, of Dana-Farber Cancer Institute presented the OPTIMISMM study, which examined Vd with or without pomalidomide. Historically, pomalidomide was relegated to very advanced lines of therapy, says Chari. The initial MM-003 study enrolled patients with a median of 5 prior lines of therapy. In heavily treated patients, the response rate was only about 30%. Moreover, progression-free survival (PFS) was only about 4 months.

To improve upon this response, pomalidomide was examined in combination and tested in earlier lines of therapy. OPTIMISMM showed that when you move pomalidomide earlier, you get a significant improvement in PFS and response rates. The regimen now serves as another treatment option for patients in relapse, states Chari, even in those who are refractory to lenalidomide (Revlimid).