Document Detail


Activity of pomalidomide in patients with immunoglobulin light-chain amyloidosis.
MedLine Citation:
PMID:  22493299     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Immunoglobulin light-chain (AL) amyloidosis is a rare, incurable plasma cell disorder. Its therapy has benefited immensely from the expanding drug armamentarium available for multiple myeloma. Pomalidomide in combination with weekly dexamethasone (Pom/dex) is active among patients with relapsed myeloma. In the present study, we explored the Pom/dex combination in patients with previously treated AL. Patients were eligible for this prospective phase 2 trial if they had had at least one prior regimen and if they had reasonably preserved organ function. Patients were treated with oral Pom/dex. Thirty-three patients were enrolled. The median age was 66 years. Median time from diagnosis to on-study was 37 months. Eighty-two percent had cardiac involvement. The confirmed hematologic response rate was 48%, with a median time to response of 1.9 months. Organ improvement was documented in 5 patients. The median overall and progression-free survival rates were 28 and 14 months, respectively; the 1-year overall and progression-free survival rates were 76% and 59%, respectively. There was a discordance between the hematologic response and the N-terminal pro-brain natriuretic peptide response. The most common grade 3-5 adverse events, regardless of attribution, were neutropenia and fatigue. We conclude that pomalidomide appears to be a valuable drug covering an unmet clinical need in patients with previously treated AL. The trial is registered at www.clinicaltrials.gov as NCT00558896.
Authors:
Angela Dispenzieri; Francis Buadi; Kristina Laumann; Betsy LaPlant; Suzanne R Hayman; Shaji K Kumar; David Dingli; Steven R Zeldenrust; Joseph R Mikhael; Robert Hall; S Vincent Rajkumar; Craig Reeder; Rafael Fonseca; P Lief Bergsagel; A Keith Stewart; Vivek Roy; Thomas E Witzig; John A Lust; Stephen J Russell; Morie A Gertz; Martha Q Lacy
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Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-04-04
Journal Detail:
Title:  Blood     Volume:  119     ISSN:  1528-0020     ISO Abbreviation:  Blood     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-06-08     Completed Date:  2012-08-15     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  7603509     Medline TA:  Blood     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5397-404     Citation Subset:  AIM; IM    
Affiliation:
Division of Hematology, Department of Medicine, Mayo Clinic Rochester, Rochester, NY, USA. dispenzieri.angela@mayo.edu
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00558896
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Amyloidosis / drug therapy*,  metabolism,  pathology
Antineoplastic Agents / adverse effects,  therapeutic use*
Dexamethasone / adverse effects,  therapeutic use*
Disease-Free Survival
Drug Therapy, Combination / adverse effects
Female
Hematologic Tests
Humans
Immunoglobulin Light Chains / metabolism*
Male
Middle Aged
Plasma Cells / drug effects*,  metabolism,  pathology
Thalidomide / adverse effects,  analogs & derivatives*,  therapeutic use
Grant Support
ID/Acronym/Agency:
P30 CA 15083/CA/NCI NIH HHS
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Immunoglobulin Light Chains; 0/pomalidomide; 50-02-2/Dexamethasone; 50-35-1/Thalidomide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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