Revista medica de Chile · 2025
[Use of Daratumumab, Carfilzomib and Pomalidomide in Patients with Relapsed Multiple Myeloma: A Current High-Efficacy Treatment].
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Samaniego E Francisco, Conte L Guillermo
Аннотация
UNLABELLED: Multiple myeloma (MM) is a malignancy derived from plasma cells. Advances in treatment have improved survival in MM patients; however, it remains incurable, and most patients will relapse. Rescue treatments based on daratumumab, carfilzomib, and pomalidomide have shown good results internationally, but there is a lack of data on their effectiveness and safety in Chile.
AIM: To evaluate the outcomes of these treatments in patients with relapsed or refractory multiple myeloma (RRMM) treated at the Clinical Hospital of the University of Chile.
MATERIALS AND METHODS: A retrospective descriptive study was conducted, including patients over 18 years of age with RRMM treated with regimens based on daratumumab, carfilzomib and/ or pomalidomide. Data were obtained from electronic medical records. The response rates, progression-free survival (PFS), overall survival (OS), and adverse events were analyzed.
RESULTS: A total of 15 patients with RRMM were included, with a mean age of 67 years and an average of 3 prior treatment lines. Of the patients, 86.6% were refractory to lenalidomide, and 46.6% were refractory to both lenalidomide and bortezomib. The response rates were as follows: 6.6% stable disease, 26.6% partial response, 53.3% very good partial response, and 13.3% complete response. The median PFS was 20 months, and the OS was not reached. Four patients (26.6%) died-three from progression of the myeloma and one from infection. The most common adverse events were infections and infusion reactions. Treatments were well tolerated.
CONCLUSIONS: Rescue treatment with daratumumab, carfilzomib, and/or pomalidomide was shown to be effective and safe in heavily pretreated patients with RRMM. PFS and OS were favorable compared to international studies, although the responses were less deep. These results are relevant for advocating the inclusion of these medications in the national health guarantees program, where treatment options for RRMM are very limited.
AIM: To evaluate the outcomes of these treatments in patients with relapsed or refractory multiple myeloma (RRMM) treated at the Clinical Hospital of the University of Chile.
MATERIALS AND METHODS: A retrospective descriptive study was conducted, including patients over 18 years of age with RRMM treated with regimens based on daratumumab, carfilzomib and/ or pomalidomide. Data were obtained from electronic medical records. The response rates, progression-free survival (PFS), overall survival (OS), and adverse events were analyzed.
RESULTS: A total of 15 patients with RRMM were included, with a mean age of 67 years and an average of 3 prior treatment lines. Of the patients, 86.6% were refractory to lenalidomide, and 46.6% were refractory to both lenalidomide and bortezomib. The response rates were as follows: 6.6% stable disease, 26.6% partial response, 53.3% very good partial response, and 13.3% complete response. The median PFS was 20 months, and the OS was not reached. Four patients (26.6%) died-three from progression of the myeloma and one from infection. The most common adverse events were infections and infusion reactions. Treatments were well tolerated.
CONCLUSIONS: Rescue treatment with daratumumab, carfilzomib, and/or pomalidomide was shown to be effective and safe in heavily pretreated patients with RRMM. PFS and OS were favorable compared to international studies, although the responses were less deep. These results are relevant for advocating the inclusion of these medications in the national health guarantees program, where treatment options for RRMM are very limited.