PS1412 POMALIDOMIDE 3RD LINE VERSUS 4TH LINE FOR IN EARLY RELAPSED REFRACTORY MULTIPLE MYELOMA

Background: Pomalidomide in association with dexamethasone is approved for relapsed and refractory Mutiple Myeloma (RRMM) in 3 rd line and beyond based on the multicenter international phase 3MM‐003 study that demonstrated greater efficacy for Pomalidomide plus dexamethasone over high dose dexamethasone. However, MM‐003 mainly recruited RRMM with 5 prior lines +, and very few data are available regarding real life Pomalidomide‐based treatment in 3 rd and 4 th line RRMM. Aims: The aim of this study was to study efficacy and safety of Pomalidomide‐based treatment in 3 rd and 4 th line for RRMM. Methods: This study is a retrospective, multicenter study based on 108 consecutive RRMM treated with Pomalidomide‐based treatment in 3 rd and 4 th line. All assessment made according to IMWG. Results: Median age was 62.5 (range, 30–86), with 36% older than 65 years, sex ratio M/F 1.25 and ISS disease stage 2 or 3 in 58%. 100% patients received previous treatment with Bortezomib and Lenalidomide and 34,2% had previously an autologous stem cell transplantation. 52 patients (48%) had pomalidomide‐based therapy as 3 rd , and 56 (52%) as 4 th line. 74% of patients received a double‐based therapy (Pomalidomide plus Dexamethasone) and 26% received a triple based therapy (Pomalidomide, Cyclophosphamide and Dexamethasone). Overall ORR was 55%, with 25% more than VGPR including 3 complete response with Pomalidomide‐based as 3 rd line. ORR was 53% with 16% ≥ VGPR including 1 CR for Pomalidomide‐based as 4th line. With a median follow‐up of 24 months, 58% and 48% at relapsed and died, respectively, in 3 rd line, and similarly, 74% and 50% in 4 th line. The median TTP was 7 (CI95% 1.4;12.6) and 9 (6.1;11.9) months in 3 rd and 4 th line, and the median OS 17 (7.8;26.1) and 23 (12.6;33.4) months, respectively. 22% and 30% have discontinued and reduced pomalidomide‐based treatment respectively. No patient died related to adverse events. AEs leading to pomalidomide‐based modification in schema included hematological AEs in 40% and non‐hematological AEs in 12% of patients. Overall, the most common adverse events grade 3 or 4 were neutropenia (22%), anemia (11%), thrombocytopenia (7%) and infectious disease (5%). Summary/Conclusion: Pomalidomide‐based therapy demonstrates efficacy in the real life with a manageable safety profile. Further study ill look into triplet versus doublet pomalidomide‐based regimen, with a benefit expected for the former. Further prospective studies are warranted to confirm this data on a larger MM population.