Pomalidomide: A Review in Relapsed and Refractory Multiple Myeloma

Pomalidomide (Imnovid^®; Pomalyst^®), an analogue of thalidomide, is an immunomodulatory agent, with several mechanisms of action (both direct and indirect) thought to be involved in its anti-myeloma activity. Oral pomalidomide is available in several countries for use in combination with low-dose dexamethasone in adults with relapsed and refractory multiple myeloma. In multinational, phase II or III studies in patients with refractory, or relapsed and refractory multiple myeloma who had received ≥ 2 prior treatment regimens (including ≥ 2 cycles of both lenalidomide and bortezomib), pomalidomide plus low-dose dexamethasone was associated with prolonged progression-free survival (PFS) and overall survival and an improved overall response rate. Pomalidomide plus low-dose dexamethasone had a manageable tolerability profile, with neutropenia, infections, anaemia and thrombocytopenia being the most frequently reported grade 3 or 4 treatment-emergent adverse events. In conclusion, pomalidomide plus low-dose dexamethasone extends the treatment options available for the management of relapsed and refractory multiple myeloma in a patient population that has very limited treatment options.