ASH Clinical News ACN_4.1_FULL_ISSUE_DIGITAL | Page 51

POMALYST ® (pomalidomide) is a thalidomide analogue indicated, in combination with dexamethasone, for patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor and have demonstrated disease progression on or within 60 days of completion of the last therapy. POMALYST + low-dose dex signifi cantly prolonged overall survival • Hazard ratio 0.70 (95% CI: 0.54, 0.92; P =0.009) vs high-dose dex 1.0 Overall survival (ITT population) 0.8 POMALYST + low-dose dex High-dose dex 0.6 0.4 0.2 Hazard ratio (95% CI) 0.70 (0.54, 0.92) Log-rank P-value=0.009 (2-sided) Data cutoff: March 1, 2013 Kaplan Meier median: POMALYST + low-dose dex=12.4 [10.4, 15.3] Kaplan Meier median: high-dose dex=8.0 [6.9, 9.0] Events: POMALYST + low-dose dex=147/302; high-dose dex=86/153 0.0 0 3 6 9 12 15 18 21 24 0 Overall survival, months Number of patients at risk: POMALYST + low-dose dex 302 248 199 126 71 32 12 1 High-dose dex 153 112 84 44 24 11 3 0 CI, confi dence interval; ITT, intent-to-treat. POMALYST + low-dose dex is the only approved therapy that has an OS benefi t in patients with relapsed/refractory myeloma who failed REVLIMID ® (lenalidomide) and bortezomib Progression-free survival (primary endpoint) was signifi cantly longer with POMALYST + low-dose dex vs high-dose dex • Hazard ratio 0.45 (95% CI: 0.35, 0.59; P <0.001) Study Design: Phase 3 multicenter, randomized, open-label study, where POMALYST + low-dose dex was compared with high-dose dex in patients with relapsed and refractory multiple myeloma, who had received at least 2 prior treatment regimens, including REVLIMID and bortezomib, and demonstrated disease progression on or within 60 days of the last therapy (ITT population, N=455). Key exclusion criteria: Serum bilirubin >2.0 mg/dL, AST/ALT >3.0 x upper limit of normal, creatinine clearance <45 mL/min. Patients in the POMALYST + low-dose dex arm (n=302) were administered 4 mg POMALYST orally on Days 1-21 of each 28-day cycle. Low-dose dex (40 mg a ) was administered once per day on Days 1, 8, 15, and 22 of a 28-day cycle. For the high-dose dex arm (n=153), dex (40 mg a ) was administered once per day on Days 1-4, 9-12, and 17-20 of a 28-day cycle. Treatment continued until patients had disease progression. a Patients >75 years of age started treatment with 20 mg dex using the same schedule. In the Phase 3 trial, OS was based on the assessment by the Independent Review Adjudication Committee (IRAC) review at the fi nal OS analysis.