{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T02:37:08Z","timestamp":1768703828380,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T00:00:00Z","timestamp":1557878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The efficacy of daratumumab (DARA) both as a monotherapy and in combination with standard\u2010of\u2010care regimens in multiple myeloma (MM) has been established in clinical trials. This article presents a retrospective analysis of the safety and efficacy of DARA in combination with pomalidomide (POM) and dexamethasone (ie, daratumumab, pomalidomide, and dexamethasone [DARA\u2010POM\u2010D]) and, more importantly, the long\u2010term follow\u2010up of a cohort that was naive to DARA and POM as well as a cohort in which the utility of re\u2010treatment was evaluated among patients who were DARA\u2010 and\/or POM\u2010refractory.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Thirty\u2010four consecutive patients with relapsed and\/or refractory MM treated with DARA\u2010POM\u2010D at the Winship Cancer Institute of Emory University from January 2015 through July 2016 were included in the analysis. The study was approved by Emory University's institutional review board. All received prior proteasome inhibitors and immunomodulatory drugs (IMiDs) and were refractory to their last line of therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All patients were lenalidomide\u2010refractory, and 91% were bortezomib\u2010refractory. Two cohorts were identified on the basis of prior exposure to DARA and\/or POM. Cohort 1 (12 patients) was DARA\u2010 and POM\u2010naive, and cohort 2 (22 patients) was DARA\u2010 and\/or POM\u2010refractory. A subgroup of 12 patients in cohort 2 (cohort 3) was DARA\u2010 and POM\u2010refractory. The combination's tolerability was consistent with the results of the published phase 1b study (EQUULES) that evaluated the combination and no new safety signals were observed. The overall response rates (ORRs) were 91.7%, 40.9%, and 33.3% in cohorts 1, 2, and 3, respectively. Deep responses, including 4 stringent complete responses, were observed in cohort 1. In cohort 2, the ORR comprised 8 partial responses (PRs) and 1 very good PR. The median progression\u2010free survival (PFS) was not reached in cohort 1 at a median follow\u2010up of 41\u00a0months, and it was 3.2\u00a0months in cohort 2. DARA\u2010POM\u2010D not only was effective in DARA\u2010 and POM\u2010naive patients but also produced clinical responses in a third of patients re\u2010treated with these drugs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A better than quadrupled PFS benefit observed in cohort 1 in comparison with the previously reported benefit in the EQUULEUS trial (which led to US Food and Drug Administration approval of the DARA\u2010POM\u2010D combination) highlights the fact that the introduction of monoclonal antibody combination strategies and IMiDs as earlier lines of therapeutic options potentially could deliver better clinical outcomes. One\u2010third of patients refractory to separate lines of DARA and\/or POM responded when they were re\u2010treated with a combination, and this resulted in survival benefits equivalent to those of other antimyeloma agents\/combinations available for DARA\u2010refractory patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.32178","type":"journal-article","created":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T09:56:07Z","timestamp":1557914167000},"page":"2991-3000","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":80,"title":["Clinical efficacy of daratumumab, pomalidomide, and dexamethasone in patients with relapsed or refractory myeloma: Utility of re\u2010treatment with daratumumab among refractory patients"],"prefix":"10.1002","volume":"125","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4165-6869","authenticated-orcid":false,"given":"Ajay K.","family":"Nooka","sequence":"first","affiliation":[{"name":"Department 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A.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charise","family":"Gleason","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence H.","family":"Boise","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute, Emory University Atlanta Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sagar","family":"Lonial","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute, Emory University Atlanta 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