Pomalidomide, Cyclophosphamide and Dexamethasone ( PCd ): Outcomes in Patients With Double‐ or Triple‐Refractory Multiple Myeloma

Double- and triple-refractory multiple myeloma (RRMM) still represents a considerable clinical challenge. Pomalidomide, cyclophosphamide and dexamethasone (PCd) remain a valid treatment option in this setting. This retrospective, multicentric study evaluated the activity and safety of PCd in patients with RRMM treated following standard clinical practice. A total of 179 patients were included. The median age was 72 years; most were triple-refractory (59.8%), being 162 patients (90.5%) refractory to lenalidomide and 117 (65.4%) to anti-CD38. The overall response rate (ORR) was 59.8% (95% CI: 52.2-67.0). Triple-refractory patients had an ORR of 52.3% (95% CI: 42.5-62.1). The median progression-free survival (PFS) and overall survival (OS) were 7.9 months (95% CI: 6.8-10.1) and 16.1 months (95% CI: 12.8-20.5), respectively. Patients refractory to lenalidomide and anti-CD38 had a median PFS of 7.6 months (95% CI: 5.8-9.4) and 7.6 months (95% CI: 5.8-9.4), respectively. Most frequent grade 3-4 adverse events were neutropenia (57.5%), anaemia (30.7%) and thrombocytopenia (29.6%). PCd demonstrated effectiveness in double- and triple-refractory RRMM patients, including those refractory to anti-CD38 and is a viable treatment option for these patients.