Hi,
My mother's myeloma is no longer responding to Revlimid, Velcade, or Carflizomib. Her oncologist has started her on Pomalyst, but is not giving dexamethasone along with it. My understanding is that Pomalyst as a single agent therapy is not nearly as effective as when it's combined with dexamethasone.
Is anyone else taking Pomalyst as a single agent or could someone comment on whether this seems like a good idea?
Thanks and blessings,
Lisa
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Lisa B. - Name: Lisa B.
- Who do you know with myeloma?: My mother, Barbara Henson
- When were you/they diagnosed?: 10-28-11
- Age at diagnosis: 71
Re: Pomalyst (pomalidomide) as single agent therapy?
I have begun taking Pomalyst + dex today! Yes, the numbers are all better if you take dex with it.
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MikeJBaron - Name: Mike J Baron
- Who do you know with myeloma?: I have myeloma
- When were you/they diagnosed?: 2004
- Age at diagnosis: 56
Re: Pomalyst (pomalidomide) as single agent therapy?
Hi Lisa,
It does seem a bit odd that your mother's doctor is not giving dexamethasone along with the Pomalyst. You should ask the doctor if there is any particular reason for that decision.
Here is a link to Pomalyst's prescribing information:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/204026lbl.pdf
If you look at Table 6 on page 11, you'll see that, in the (heavily pretreated) patients treated with just Pomalyst, without any dex, only 7.4% responded to treatment.
In a similar group of patients treated with Pomalyst plus low-dose dex, on the other hand, 29.2% of the patients responded.
So dex seems to make a big difference in how effective Pomalyst is.
If your mother's doctor is concerned that your mother can't tolerate the dex, an alternative might be prednisone, which is the same type of drug as dex, but often better tolerated than dex.
I don't think there are any data comparing Pomalyst alone to Pomalyst plus prednisone, but I think it's reasonable to assume that adding prednisone to Pomalyst would improve the response rate just like adding dex does.
It does seem a bit odd that your mother's doctor is not giving dexamethasone along with the Pomalyst. You should ask the doctor if there is any particular reason for that decision.
Here is a link to Pomalyst's prescribing information:
http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/204026lbl.pdf
If you look at Table 6 on page 11, you'll see that, in the (heavily pretreated) patients treated with just Pomalyst, without any dex, only 7.4% responded to treatment.
In a similar group of patients treated with Pomalyst plus low-dose dex, on the other hand, 29.2% of the patients responded.
So dex seems to make a big difference in how effective Pomalyst is.
If your mother's doctor is concerned that your mother can't tolerate the dex, an alternative might be prednisone, which is the same type of drug as dex, but often better tolerated than dex.
I don't think there are any data comparing Pomalyst alone to Pomalyst plus prednisone, but I think it's reasonable to assume that adding prednisone to Pomalyst would improve the response rate just like adding dex does.
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JimNY
Re: Pomalyst (pomalidomide) as single agent therapy?
Jim and Mike,
Thank you so much for the responses! I contacted my mother's oncologist and discovered that he had forgotten to give her a prescription for the dexamethasone. Apparently, he did not even realize this and assumed she was taking it! She is the first and only patient at this particular oncology practice who is taking Pomalyst, so I would have thought her doctor would have been extra vigilant in ensuring everything was "by the book"! I'm very upset about this and so glad I followed up!
Thanks again for taking time to reply.
Lisa
Thank you so much for the responses! I contacted my mother's oncologist and discovered that he had forgotten to give her a prescription for the dexamethasone. Apparently, he did not even realize this and assumed she was taking it! She is the first and only patient at this particular oncology practice who is taking Pomalyst, so I would have thought her doctor would have been extra vigilant in ensuring everything was "by the book"! I'm very upset about this and so glad I followed up!
Thanks again for taking time to reply.
Lisa
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Lisa B. - Name: Lisa B.
- Who do you know with myeloma?: My mother, Barbara Henson
- When were you/they diagnosed?: 10-28-11
- Age at diagnosis: 71
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