CancerNetwork® met with Fredrik Schjesvold, MD, PhD, at the International Myeloma Workshop 2021 to discuss the differences in safety profiles between melflufen / dexamethasone and pomalidomide / dexamethasone in relapsed / refractory multiple myeloma.
At the International Myeloma Workshop 2021, CancerNetwork® spoke with Fredrik Schjesvold, MD, PhD, founder and director of the Oslo Myeloma Center, about the differences in safety profile between melflufen (Pepaxto) / dexamethasone and pomalidomide ( Pomalyst) / dexamethasone, as seen in the OCEAN Phase 3 trial (NCT03151811).
[Regarding the safety profile], there were differences, mainly in cytopenias where there were more cytopenias of all kinds for melflufen. [However], there were more infections in the pomalidomide arm. It seems that an increase in neutropenia no longer gives rise to infections. The safety concern of melflufen is in transplant patients, who appear to have prolonged cytopenia after treatment. [with] melflufen, which probably makes them less tolerant of further treatment. This is adding to the detriment of the survival of the pre-transplant patients, as it appears to be the pre-transplant patients that are experiencing this prolonged bone marrow suppression due to melflufen and we are not seeing it. in non-transplant patients. . From a safety point of view, as long as the treatment was going on, there were no big signals. The problem is after the end of the treatment, [and patients] go to the next treatment [and] you see this transplant in patients. In addition, melflufen poses a longer-term problem.
Schjesvold F, Dimopoulos MA, Delimpasi S, et al. OCEAN (OP-103): a phase 3, randomized, global and direct comparative study of melflufen and dexamethasone (Dex) versus pomalidomide (Pom) and dex in relapsed refractory multiple myeloma (RRMM). Presented at: International Myeloma Workshop; from September 8 to 11, 2021; Vienna, Austria. Accessed September 11, 2021.