Why is Pomalidomide useful in Multiple Myeloma Treatment?

Plasma cell myeloma, most commonly known as multiple myeloma (MM) is characterized by the proliferation of malignant plasma cells within the bone marrow, which helps in producing an abnormal monoclonal paraprotein and evidence of end-organ damage. As this disease progresses frequent infections, anemia and bone marrow bleeding may occur. The cause of multiple myeloma is unspecified but some risk factors may be responsible such as, family history, radiation exposure, and obesity.

This disease may develop from the monoclonal gammopathy of undetermined significance that progresses to smoldering myeloma.

The disease is considered treatable and the remissions may be brought about chemotherapy, steroids, targeted therapy, and stem cell transplant. Radiation therapy and Bisphosphonates are often used in order to reduce the pain from bone lesions. 

According to the previous studies pomalidomide may be useful in patients with multiple myeloma which is not responding to other treatments.
Pomalidomide mainly belongs to a class of drugs called immunomodulating agents.

This multiple myeloma drug is helpful in a couple of ways:

· It helps the bone marrow in order to produce normal blood cells.

· Also, it enhances the ability as well as the strength of immune cells in order to kill abnormal cells in the bone marrow.

In the month of February in 2013, the US FDA (Food and Drug Administration) approved pomalidomide as the treatment of patient with relapsed and refractory multiple myeloma, in people who have received minimum couple of prior therapies including Bortezomib and lenalidomide 25 mg and whose disease progressed within 60 days of completion of the last therapy.

Pomalidomide has dual effects, it directly inhibits angiogenesis and myeloma cell growth. Also, upregulation of interferon gamma, IL-2 and IL-10 as well as downregulation of IL-6 have been reported for pomalidomide 4 mg.

How Pomalidomide Works: Pomalidomide, an analogue of thalidomide, is an immunomodulatory agent with antineoplastic activity. In in vitro cellular essays this medication inhibited proliferation and induced apoptosis of hematopoietic tumor cells.

Also, this medication inhibited the proliferation of pomalidomide-resistant multiple myeloma cell lines and synergized with dexamethasone in both lenalidomide-sensitive and lenalidomide-resistant cell lines in order to induce tumor cell apoptosis.

Pomalidomide helps in order to increase T-cells and natural killer (NK) cell-mediated immunity and inhibits the production of pro-inflammatory cytokines by monocytes. Also, this medication demonstrated anti-angiogenic activity in a mouse tumor model and in the in vitro umbilical cord model.

Side Effects of Pomalidomide: Patients with this medication may experience some most common side effects include nausea, fatigue, diarrhea, anemia, constipation, dyspnea, upper respiratory tract infections, asthenia, back pain, and neutropenia.

A serious, as well as rare adverse reaction of pomalidomide, is blood clots forming in the legs or lungs. Immediately call your healthcare provider if you experience any of the above-mentioned terms as signs and symptoms.

Dosage and Administration: Patients should be taken Pomalidomide 4 mg per day orally on days 1–21 of repeated 28-day cycles until disease progression.
This medication comes in the form of capsules as the strength of 1 mg, 2 mg, 3 mg, and 4 mg.

Multiple Myeloma Treatment Drugs: Apart from Pomalidomide, which is the newest treatment for multiple myeloma, there are some other multiple myeloma medications available, which are enlisted as follows:

Chemotherapy Drugs:), Cyclophosphamide (Cytoxan), Bendamustine (Treanda), Doxorubicin (Adriamycin), Etoposide (VP-16), Liposomal doxorubicin (Doxil), Vincristine (Oncovin). 

Melphalan (Alkeran, Evomela).  Corticosteroids: ( Dexamethasone, Prednisone). 

Immunomodulators: Lenalidomide (Revlimid), Thalidomide (Thalomid)

Monoclonal Antibodies: Daratumumab (Darzalex), Elotuzumab (Empliciti). 

Histone Deacetylase (HDAC) Inhibitors: Panobinostat (Farydak). 

Proteasome Inhibitors: Bortezomib (Velcade), carfilzomib 60 mg (Kyprolis), Ixazomib (Ninlaro). 

You just need to stick with your multiple myeloma treatment plan because pomalidomide has potential to work better against your cancer and is able to lead you towards quality of life. Take Pomalidomide as prescribed by your healthcare provider in order to get healthy outcomes.

Read - Latest Treatment for Multiple Myeloma