At what stage of myeloma do you need to take pomalidomide?

After many patients are diagnosed with multiple myeloma (MM), they will be concerned about a question: Do they have to wait until the late stage or several stages before using pomalidomide? Actually, this question cannot be answered simply by “instalment”. Treatment decisions for multiple myeloma are usually not entirely based on international staging systems (such as ISS or R-ISS), but more emphasis is placed on previous treatment history, duration of response, and whether the disease relapses or is drug-resistant.

The main clinical positioning of Pomalidomide is "relapsed or refractory multiple myeloma". In other words, the pomalidomide regimen will only be considered when the disease progresses again after the patient has received multiple lines of treatment, especially after using lenalidomide and proteasome inhibitors.

Judging from the actual situation, although some patients are not very advanced in stage, if their response to previous treatment options gradually weakens or progresses in a short period of time, they may enter the applicable population of pomalidomide in advance. Pomalidomide is usually used in combination with dexamethasone rather than as monotherapy. This combination regimen is designed to enhance immune regulation and improve the ability to control drug-resistant myeloma cells.

It needs to be emphasized that the decision of whether to use pomalidomide is not made by the patient, but is based on a comprehensive evaluation of multiple factors, including physical tolerance, bone marrow function status, infection risk, and past history of adverse reactions. Therefore, instead of worrying about "at what stage of myeloma should pomalidomide be used", it is better to understand that when the disease is no longer sensitive to first-line and second-line treatments, pomalidomide becomes one of the important later-line treatment options.

Keyword tags: pomalidomide applicable population, myeloma medication stage,Pomalidomide treatment timing, relapsed and refractory myeloma, myeloma back-line treatment options

Reference materials:https://go.drugbank.com/drugs/DB08910