Side Effects of pomalidomide: A Synthesis of Findings from 27 Studies

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Original Abstract of the Article

Major Research Findings

Pomalidomide is an immunomodulatory drug used to treat multiple myeloma, a type of blood cancer. 6 , 18 , 27 . It works by directly inhibiting the growth and spread of myeloma cells. 27 This drug has been shown to be effective in treating patients who have relapsed or are refractory to other treatments, including lenalidomide. 12 , 11 Pomalidomide is also being investigated in combination with other drugs, such as proteasome inhibitors and monoclonal antibodies, to improve treatment outcomes. 17 A pooled analysis of clinical trials showed that the combination of pomalidomide and low-dose dexamethasone is well-tolerated and effective in managing adverse events. 16 .

Pomalidomide has also been shown to cause lung adverse events. 2 A large pharmacovigilance database in Japan has also revealed that pomalidomide can cause visual impairment. 3 .

Reasons for Side Effects

The side effects of pomalidomide are thought to be caused by its mechanism of action, which involves binding to Cereblon (CRBN) and altering the substrate specificity of the CRBN E3 ubiquitin ligase complex. This results in the degradation of certain proteins in the cell, such as Ikaros and Aiolos. 5 .

Common Side Effects

Thrombocytopenia

Pomalidomide can cause a decrease in platelet count, which can lead to increased risk of bleeding. 27 , 16 , 7

Neuropathy

Pomalidomide can cause nerve damage, leading to pain, numbness, and tingling in the hands and feet. 27 , 16 , 7 , 23

Deep Vein Thrombosis

Pomalidomide can increase the risk of blood clots in the legs. 27

Lung Adverse Events

Pomalidomide has been associated with lung problems, such as pneumonia and shortness of breath. 2 .

Visual Impairment

Pomalidomide has been linked to visual problems, such as blurred vision and eye pain. 3 .

Infection

Pomalidomide can weaken the immune system, making patients more susceptible to infections. 7

Hypertension

Pomalidomide can cause high blood pressure. 7

Side Effect Management

Thrombocytopenia

Blood transfusions and platelet transfusions may be used to manage low platelet counts. 27 , 16 , 7

Neuropathy

Vitamin B complex and antiepileptic medications can be prescribed to help manage nerve damage. 27 , 16 , 7 , 23

Deep Vein Thrombosis

Anticoagulants are used to prevent blood clots from forming in the legs. 27

Lung Adverse Events

Treating lung problems may involve the use of steroids and other supportive care. 2 .

Visual Impairment

Patients should consult an ophthalmologist for any vision problems that arise. 3 .

Infection

Vaccines and antibiotics are used to prevent and treat infections. 7

Hypertension

Antihypertensive drugs are used to manage high blood pressure. 7

Comparison Between Studies

Commonalities

Multiple research studies have shown the effectiveness of pomalidomide in treating multiple myeloma. They also consistently report side effects such as thrombocytopenia, neuropathy, and deep vein thrombosis. 27 , 18 , 16 , 11 .

Differences

The frequency and severity of side effects caused by pomalidomide can vary from one study to another. 27 , 16 , 7 Additionally, side effects associated with pomalidomide in combination therapy with other drugs may differ across studies. 17 .

Precautions for Real-Life Application

Pomalidomide is an effective medication for treating multiple myeloma, but it comes with the risk of side effects. It's crucial to discuss the potential risks and benefits of pomalidomide with your doctor and make a treatment decision together. 27 , 18 , 16 , 11 .

Limitations of Current Research

More research is needed to fully understand the side effects of pomalidomide. The long-term impact of pomalidomide and its side effects in specific patient populations require further investigation. 21 , 8 .

Future Research Directions

Developing new treatments and preventative measures to minimize the side effects of pomalidomide is essential. Research into biomarkers that can predict these side effects is also necessary. 9 . Developing new treatments and preventative measures to minimize the side effects of pomalidomide is essential. Research into biomarkers that can predict these side effects is also necessary. 9 .

Conclusion

Pomalidomide has proven to be an effective treatment option for multiple myeloma. However, it's important to be aware of the potential side effects. Before starting pomalidomide treatment, discuss the risks and benefits thoroughly with your doctor. Further research is crucial to gain a deeper understanding of the side effects of pomalidomide. 27 , 18 , 16 , 11 , 9 .

Literature analysis of 27 papers
Positive Content
26
Neutral Content
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Negative Content
1
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25
4.

The Ubiquitination-Dependent and -Independent Functions of Cereblon in Cancer and Neurological Diseases.

Author: ZhouLiang, XuGuoqiang

Cancer treatment
Neurological disease treatment

Cereblon (CRBN) is a protein that plays a role in the teratogenic effects of thalidomide and the anti-myeloma effects of immunomodulatory drugs (IMiDs). This review discusses the functions of CRBN, including its role in ubiquitination and proteasome-mediated degradation. The review also explores the potential future directions for CRBN ligand-based drug discovery in the treatment of cancer and neurological diseases.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

5.

Rapid Progress in the Use of Immunomodulatory Drugs and Cereblon E3 Ligase Modulators in the Treatment of Multiple Myeloma.

Author: CharlińskiGrzegorz, VesoleDavid H, JurczyszynArtur

MM survival improved
Progression-free survival extended
Lenalidomide side effects
Pomalidomide side effects
Thalidomide side effects

Immunomodulatory drugs (IMiDs) like thalidomide, lenalidomide, and pomalidomide have significantly improved outcomes for multiple myeloma (MM) patients. These drugs target the cereblon (CRBN) protein, altering the function of the CRBN E3 ubiquitin ligase complex, leading to the breakdown of Ikaros and Aiolos proteins. IMiDs have proven beneficial in extending progression-free and overall survival in patients with newly diagnosed, post-transplant, and relapsed/refractory MM. Thalidomide, due to side effects, is less frequently used. Lenalidomide, with a better safety profile, is employed at all stages of MM treatment, often in combination with proteasome inhibitors and monoclonal antibodies. Pomalidomide is reserved for relapsed/refractory MM, also with PIs and monoclonal antibodies. Current research is focused on the development of IMiD derivatives, known as CRBN E3 ligase modulators (CELMoDs). This review highlights the significant impact of IMiDs in MM treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Self-management of immunomodulatory drug treatment in multiple myeloma patients.

Author: CransacAmélie, AhoSerge, CosmeEdouard, ChretienMarie-Lorraine, FavennecCamille, SchrederLaure, BoutetMérédith, GueneauPauline, GiroudMaurice, CaillotDenis, BoulinMathieu

Valid IMID management tool

A new questionnaire for patients with multiple myeloma who are being treated with immunomodulatory drugs was validated to assess the self-capacity of patients to manage their treatment and side effects. The questionnaire was found to be a valid tool to assess adherence and side effect management skills.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

10.

Old and new generation immunomodulatory drugs in multiple myeloma.

Author: DerudasDaniele, CapraroFrancesca, MartinelliGiovanni, CerchioneClaudio

Improved outcomes for MM

This article highlights the significant improvements in the treatment of multiple myeloma (MM) over the past two decades, particularly due to the introduction of immunomodulatory drugs (IMiDs) like thalidomide, lenalidomide, and pomalidomide. IMiDs have substantially improved outcomes for MM patients.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

11.

Treatment of relapsed and refractory multiple myeloma.

Author: LeeJi Hyun, KimSung-Hyun

Improved outcomes
RRMM treatment
Drug side effects

Treating relapsed and refractory multiple myeloma requires a holistic approach that considers patient, disease, and drug-related factors.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

12.

Health-related quality-of-life results from the phase 3 OPTIMISMM study: pomalidomide, bortezomib, and low-dose dexamethasone versus bortezomib and low-dose dexamethasone in relapsed or refractory multiple myeloma.

Author: WeiselKatja, DimopoulosMeletios, MoreauPhilippe, YagciMunci, LaroccaAlessandra, KanateAbraham S, VuralFiliz, CascavillaNicola, BasuSupratik, JohnsonPeter, ByeffPeter, HusMarek, Rodríguez-OteroPaula, MuelduerErcan, AnttilaPekka, HaydenPatrick J, KrauthMaria-Theresa, LucioPaulo, Ben-YehudaDina, MendeleevaLarisa, GuoShien, YuXin, GroteLara, BiyukovTsvetan, DhanasiriSujith, RichardsonPaul

Multiple myeloma treatment

This study reports health-related quality of life (HRQoL) results from the OPTIMISMM trial, which evaluated the addition of pomalidomide to bortezomib and low-dose dexamethasone (PVd) for patients with relapsed or refractory multiple myeloma (RRMM). The HRQoL results with PVd support its use in patients with RRMM.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

13.

Therapeutic Opportunities with Pharmacological Inhibition of CD38 with Isatuximab.

Author: MartinThomas G, CorzoKathryn, ChironMarielle, VeldeHelgi van de, AbbadessaGiovanni, CampanaFrank, SolankiMalini, MengRobin, LeeHelen, WiederschainDmitri, ZhuChen, RakAlexey, AndersonKenneth C

MM treatment
Infusion reactions

This review discusses the use of anti-CD38 therapies for multiple myeloma (MM). Daratumumab and isatuximab are effective in treating relapsed/refractory MM and are well tolerated.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

14.

[Immunomodulator drugs for the treatment of multiple myeloma].

Author: Fernández-LázaroDiego, Fernández-LázaroCésar Ignacio, Caballero GarcíaAlberto, Córdova MartínezAlfredo

Anticancer effects
Immunomodulatory effects
Multiple myeloma treatment
Tolerability
Side effects

Second-generation immunomodulatory (IMiDs) compounds, lenalidomide and pomalidomide, are highly effective and well-tolerated treatment options for patients with multiple myeloma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : Spanish

15.

Cardiovascular Complications of Multiple Myeloma Treatment: Evaluation, Management, and Prevention.

Author: LeeDae Hyun, FradleyMichael G

Multiple myeloma treatment
Cardiotoxicity

Multiple myeloma treatment regimens often include proteasome inhibitors, immunomodulatory drugs, and steroids, all of which can have adverse effects on the heart. This article discusses the cardiovascular complications associated with these treatment modalities and methods to mitigate them.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Adverse event management in patients with relapsed and refractory multiple myeloma taking pomalidomide plus low-dose dexamethasone: A pooled analysis.

Author: MoreauPhilippe, DimopoulosMeletios A, RichardsonPaul G, SiegelDavid S, CavoMichele, CorradiniPaolo, WeiselKatja, DelforgeMichel, O'GormanPeter, SongKevin, ChenChristine, BahlisNizar, OriolAlbert, HanssonMarkus, KaiserMartin, AnttilaPekka, RaymakersReinier, JoaoCristina, CookGordon, SternasLars, BiyukovTsvetan, SlaughterAna, HongKevin, HerringJennifer, YuXin, ZakiMohamed, San-MiguelJesus

AE management
Myeloma therapy
Treatment-related AEs

Pomalidomide plus low-dose dexamethasone is a treatment for multiple myeloma. This combination has been shown to be safe and effective in patients who have previously received multiple treatments.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

18.

Optimizing current and emerging therapies in multiple myeloma: a guide for the hematologist.

Author: RazaShahzad, SafyanRachael A, RosenbaumEvan, BowmanAlex S, LentzschSuzanne

Improved overall survival
Improved response rates

This review outlines the current therapeutic approach to the management of multiple myeloma (MM). It highlights the advancements in treatment options, including proteasome inhibitors and immunomodulatory drugs, and emphasizes the importance of risk stratification, management of comorbidities, and treatment side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

19.

Immunomodulatory Drugs (IMiDs) in Multiple Myeloma.

Author: RazaShahzad, SafyanRachael A, LentzschSuzanne

Improved survival

This review discusses the current therapeutic approach to multiple myeloma, highlighting the role of immunomodulatory drugs and proteasome inhibitors in improving overall survival.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Immunomodulatory drugs inhibit TLR4-induced type-1 interferon production independently of Cereblon via suppression of the TRIF/IRF3 pathway.

Author: MillrineDavid, MiyataHaruhiko, TeiMami, DubeyPraveen, NyatiKishan, NakahamaTaisuke, GemechuYohannes, RipleyBarry, KishimotoTadamitsu

Inflammation inhibition

Immunomodulatory drugs (IMiDs) inhibit TLR-induced type-1 interferon production independently of Cereblon, a receptor associated with thalidomide's teratogenic effects. This discovery suggests that the therapeutic properties of IMiDs can be separated from their harmful side effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

21.

Safe and prolonged survival with long-term exposure to pomalidomide in relapsed/refractory myeloma.

Author: FouquetG, PegourieB, MacroM, PetillonM O, KarlinL, CaillotD, RousselM, ArnulfB, MathiotC, MaritG, KolbB, StoppaA M, BrechiniacS, RichezV, RodonP, BanosA, WetterwaldM, GarderetL, RoyerB, HulinC, BenboukerL, DecauxO, Escoffre-BarbeM, FermandJ P, AttalM, Avet-LoiseauH, MoreauP, FaconT, LeleuX,

Multiple myeloma treatment
Pomalidomide

This study analyzed the characteristics of patients with very advanced relapsed or refractory multiple myeloma (RRMM) who showed prolonged progression-free survival (PFS) and overall survival (OS) after treatment with pomalidomide and dexamethasone in the IFM2009-02 trial. The study also investigated the effects of long-term exposure to pomalidomide.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

22.

Long-term disease control by pomalidomide-/dexamethasone-based therapy in a patient with advanced multiple myeloma: a case report and review of the literature.

Author: DanhofSophia, SchrederMartin, StriflerSusanne, EinseleHermann, KnopStefan

Treats multiple myeloma

This article discusses the treatment of multiple myeloma (MM) and highlights the limitations of current therapies, particularly in patients with progressive disease despite treatment with novel agents. It explores the potential of pomalidomide-based combination therapies for improving treatment outcomes.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

23.

Central neurotoxicity of immunomodulatory drugs in multiple myeloma.

Author: PatelUrmeel H, MirMuhammad A, SivikJeffrey K, RahejaDivisha, PandeyManoj K, TalamoGiampaolo

Treatment of multiple myeloma
Central neurotoxicity
Peripheral neuropathy

This report describes 6 cases of significant central neurotoxicity associated with IMiD therapy (thalidomide, lenalidomide, and pomalidomide). The authors emphasize that central neurotoxicity should be recognized as an important side effect of IMiD therapy.

Case ReportsIn the medical field, a report that describes in detail a unique case, an unusual medical condition, or the effect of a treatment. Provides new insights and possibilities for treatment through individual patient cases.

Language : English

24.

Treatment-related symptom management in patients with multiple myeloma: a review.

Author: ColsonKathleen

MM survival improvement
Quality of life
Symptom management

This review discusses current MM treatment options, symptom management approaches, and supportive care strategies for patients with multiple myeloma.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

27.

Impact of pomalidomide therapy in multiple myeloma: a recent survey.

Author: KumarArvind, PorwalMayur, VermaAnkita, MishraArun K

Multiple myeloma treatment
Deep vein thrombosis
Neuropathy
Thrombocytopenia

Pomalidomide is a synthetic immunomodulatory drug that has been approved for the treatment of relapsed and refractory multiple myeloma (MM). It inhibits myeloma cell growth and angiogenesis. The most common side effects are thrombocytopenia, neuropathy, and deep vein thrombosis. Pomalidomide is also being investigated for other cancers and conditions.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

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