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Systemic Anti-Cancer Therapy Regimen Library

Home > PCN MM Relapsed - pomalidomide and dexamethasone

PCN MM Relapsed - pomalidomide and dexamethasone

Treatment Overview

Cycle 1 (and all further cycles) - 28 days

Cycle length:
28

Dexamethasone dose: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients. 

Cycle details

Cycle 1 (and all further cycles) - 28 days

Medication Dose Route Days Max Duration
dexamethasone * 40 mg flat dosing oral administration 1, 8, 15,
22
pomalidomide 4 mg Once daily oral administration 1 to 21

Dexamethasone dose: Consider dose reduction of dexamethasone to 20 mg ONCE a week in older or frail patients. 

Full details

Cycle 1 (and all further cycles) - 28 days

Day: 1

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

Consider dose reduction to 20 mg in older or frail patients.
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 2

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 3

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 4

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 5

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 6

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 7

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 8

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

Consider dose reduction to 20 mg in older or frail patients.
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 9

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 10

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 11

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 12

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 13

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 14

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 15

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

Consider dose reduction to 20 mg in older or frail patients.
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 16

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 17

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 18

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 19

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 20

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 21

Medication Dose Route Max duration Details
pomalidomide 4 mg Once daily oral administration
Instructions:
Swallow whole, do not crush or chew. This medicine may make you dizzy. Do not drive or use tools or machinery until you know how this medicine affects you. Limit alcohol intake.
Additional details:

Day: 22

Medication Dose Route Max duration Details
dexamethasone * 40 mg flat dosing oral administration
Instructions:

Take in the morning with food.

Consider dose reduction to 20 mg in older or frail patients.

Additional details

Section 1: Teratogenic effects

All patients must fulfil the requirements of the pregnancy prevention risk management programme to ensure pregnant women are not exposed to pomalidomide.

Supportive Care Factors

Factor Value
Antiviral prophylaxis for herpes virus: Routine antiviral prophylaxis may be considered
Emetogenicity: Minimal to low
Gastroprotection: Gastroprotection may be considered
Pneumocystis jirovecii pneumonia (PJP) prophylaxis: Routine antibiotic prophylaxis recommended
Thromboprophylaxis: Thromboprophylaxis is recommended
Tumour lysis syndrome prophylaxis: Tumour lysis syndrome prophylaxis may be considered

Antiviral prophylaxis for hepatitis B virus: Guidance is limited to high-risk anti-cancer medicines. Clinicians will need to assess individual patient risk for other anti-cancer medicines.

References

Lacy, M. Q., J. B. Allred and M. A. Gertz. 2011. "Pomalidomide plus low-dose dexamethasone in myeloma refractory to both bortezomib and lenalidomide: comparison of 2 dosing strategies in dual-refractory disease." Blood 118(11): 2970-2975., PMID: 21690557

Leleu, X., M. Attal and B. Arnulf. 2013. "Pomalidomide plus low-dose dexamethasone is active and well tolerated in bortezomib and lenalidomide-refractory multiple myeloma: Intergroupe Francophone du Myelome 2009-02." Blood 121(11): 1968-1975. , PMID: 23319574

San Miguel, J. S., K. Weisel and P. Moreau. 2013. "Pomalidomide plus low-dose dexamethasone versus high-dose dexamethasone alone for patients with relapsed and refractory multiple myeloma (MM-003): a randomised, open-label, phase 3 trial." The Lancet Oncology 14(11): 1055-1066. , PMID: 24007748

Dimopoulos MA, Palumbo A, Corradini P, et al Safety and efficacy of pomalidomide plus low-dose dexamethasone in STRATUS (MM-010): a phase 3b study in refractory multiple myeloma. Blood. 2016 Jul 28;128(4):497-503. doi: 10.1182/blood-2016-02-700872. Epub 2016 May 25., PMID: 27226434

Celgene Limited Pomalyst New Zealand Datasheet 31 January 2022 https://www.medsafe.govt.nz/profs/Datasheet/p/pomalystcap.pdf (Accessed 31/3/2022).

* The medicines, doses, combinations, and schedule in this treatment regimen have been carefully reviewed against international best practice guidelines by specialists in medical oncology around New Zealand and this advice has been accepted for publication by Te Aho o Te Kahu (the Cancer Control Agency). Sometimes medicines that are used in routine clinical practice have not been through a formal review process by the NZ Medicines Regulator Medsafe and are therefore considered unapproved or off-label. These medicines are legally able to be prescribed through sections 25 and 29 of the Medicines Act and by obtaining informed consent from patients. All treatment regimens listed on this website have been through robust peer review and are considered an accepted standard of care, whether prescribed through sections 25 or 29 or carrying formal Medsafe Approval.

s29: This symbol indicates that some formulations of the associated medicine are legally only able to be prescribed under section 29 of the Medicines Act. You can see which formulations are section 29 by hovering over the s29 symbol. You can access full medication details from the New Zealand Formulary by clicking on the medication name. Each clinician retains full responsibility for ensuring they have complied with all relevant obligations and requirements of section 29 including obtaining informed patient consent prior to prescribing the applicable medicine.