Multi-agent regimens incorporating immunomodulatory (IMiD®) agents such as thalidomide, lenalidomide, and pomalidomide have become the preferred standard of care for the treatment of patients with multiple myeloma (MM), resulting in improved survival outcomes. Currently, there are three IMiD agents approved for the treatment of MM: thalidomide, lenalidomide, and pomalidomide. Lenalidomide is commonly used to treat patients with newly diagnosed MM and as maintenance therapy following stem cell transplant or after disease relapse. Pomalidomide, the focus of this review, is approved in patients with relapsed/refractory MM (RRMM). Despite survival benefits, IMiD agents each have different safety profiles requiring consideration both prior to starting therapy and during treatment. Adverse event (AE) management is essential, not only to ensure treatment adherence and thus ensure optimal efficacy but also to maintain patient quality of life. Here, we discuss AEs associated with pomalidomide and present five clinically relevant hypothetical case studies in patients with RRMM to provide scenario-driven guidance regarding treatment selection and AE prevention and management in the clinical setting. Lastly, as new treatment approaches continue to be explored in MM, we also discuss novel cereblon E3 ligase modulator (CELMoD™) agents including iberdomide (CC-220) and mezigdomide (CC-92480).
包含沙利度胺、来那度胺和泊马度胺等免疫调节剂（IMiD®）的多药联合方案已成为多发性骨髓瘤（MM）患者治疗的首选标准方案，显著改善了患者的生存预后。目前，已有三种IMi剂获批用于MM治疗：沙利度胺、来那度胺和泊马度胺。来那度胺常用于新诊断MM患者的治疗，并作为干细胞移植后或疾病复发后的维持治疗。本文重点讨论的泊马度胺则获批用于复发/难治性多发性骨髓瘤（RRMM）患者。尽管IMi剂能带来生存获益，但每种药物具有不同的安全性特征，需要在治疗开始前和治疗期间予以充分考虑。不良事件（AE）管理至关重要，不仅有助于确保治疗依从性从而获得最佳疗效，还能维持患者的生活质量。本文讨论了与泊马度胺相关的不良事件，并通过五个临床相关的RRMM患者假设案例研究，为临床实践中治疗方案选择及不良事件的预防与管理提供场景化指导。最后，随着MM新治疗方法的不断探索，我们还讨论了包括伊伯度胺（CC-220）和美齐度胺（CC-92480）在内的新型cereblon E3连接酶调节剂（CELMoD™）。
肿瘤(癌症)患者之家