{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T13:06:49Z","timestamp":1784034409513,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Melphalan flufenamide (melflufen), a first\u2010in\u2010class alkylating peptide\u2010drug conjugate, plus dexamethasone demonstrated superior progression\u2010free survival (PFS), but not overall survival (OS), versus pomalidomide plus dexamethasone in relapsed\/refractory multiple myeloma in the OCEAN study. Time to progression (TTP) &lt;36\u2009months after a prior autologous stem cell transplantation (ASCT) was a negative prognostic factor for OS with melflufen. This post hoc exploratory analysis evaluated patients refractory to prior alkylators (e.g., cyclophosphamide and melphalan) in OCEAN. In 153 patients refractory to prior alkylators (melflufen, <jats:italic>n<\/jats:italic>\u2009=\u200978; pomalidomide, <jats:italic>n<\/jats:italic>\u2009=\u200975), the melflufen and pomalidomide arms had similar median PFS (5.6\u2009months [95% CI, 4.2\u20138.3] vs. 4.7\u2009months [95% CI, 3.1\u20137.3]; hazard ratio [HR], 0.92 [95% CI, 0.63\u20131.33]) and OS (23.4\u2009months [95% CI, 14.4\u201331.7] vs. 20.0\u2009months [95% CI, 12.0\u201328.7]; HR, 0.92 [95% CI, 0.62\u20131.38]). Among alkylator\u2010refractory patients with a TTP\u2009\u2265\u200936\u2009months after a prior ASCT or no prior ASCT (melflufen, <jats:italic>n<\/jats:italic>\u2009=\u200954; pomalidomide, <jats:italic>n<\/jats:italic>\u2009=\u200953), the observed median PFS and OS were longer in the melflufen arm than the pomalidomide arm. The safety profile of melflufen was consistent with previous reports. These results suggest that melflufen is safe and effective in patients with alkylator\u2010refractory disease, suggesting differentiated activity from other alkylators.<\/jats:p>","DOI":"10.1111\/ejh.14127","type":"journal-article","created":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T05:53:30Z","timestamp":1700114010000},"page":"402-411","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Melflufen in relapsed\/refractory multiple myeloma refractory to prior alkylators: A subgroup analysis from the <scp>OCEAN study<\/scp>"],"prefix":"10.1111","volume":"112","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1096-0569","authenticated-orcid":false,"given":"Fredrik H.","family":"Schjesvold","sequence":"first","affiliation":[{"name":"Oslo Myeloma Center, Department of Hematology Oslo University Hospital  Oslo Norway"},{"name":"KG Jebsen Center for B Cell Malignancies University of Oslo  Oslo 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