{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:22:34Z","timestamp":1775438554042,"version":"3.50.1"},"reference-count":31,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004826","name":"Beijing Natural Science Foundation","doi-asserted-by":"publisher","award":["7242075"],"award-info":[{"award-number":["7242075"]}],"id":[{"id":"10.13039\/501100004826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Although multiple pomalidomide-based combinations are active in relapsed and\/or refractory multiple myeloma (RRMM), comparative data to guide regimen selection remain limited. Methods: A total of 230 patients with RRMM from 12 centers in China who received pomalidomide-based regimens were included in this retrospective analysis. Overall response rate (ORR) and progression-free survival (PFS) were compared across regimens incorporating bortezomib or ixazomib (V\/IPD), carfilzomib (KPD), or daratumumab (DPD), and multivariable analyses were performed to identify prognostic factors. Results: The overall ORR was 73.9%, with rates of 63%, 79%, and 85% in the V\/IPD (n = 66), KPD (n = 69), and DPD (n = 95) cohorts, respectively. ORR differed significantly between V\/IPD and DPD (p = 0.0165), driven by a higher proportion of \u2265VGPR in the DPD group. The median PFS for the entire cohort was 17.4 months (95% CI: 13.7\u201320.1), compared with 15.4 months (95% CI: 12.8\u201320.5), 14.2 months (95% CI: 6.9\u2013not estimable), and 19.2 months (95% CI: 15.1\u201324.9) for V\/IPD, KPD, and DPD, respectively, without significant differences. In multivariable analysis, DPD was associated with improved ORR (HR 4.83, p &lt; 0.001) but not with PFS. R-ISS stage III predicted inferior response (HR 0.35, p = 0.04), whereas \u22653 prior lines of therapy correlated with shorter PFS (HR 1.77, p = 0.012). Adverse events were predominantly hematologic, with limited grade 3\u20134 toxicity and no treatment-related mortality. Conclusions: This multicenter real-world analysis clarifies the relative positioning of commonly used pomalidomide-based regimens in RRMM and underscores the importance of treatment timing and disease stage in optimizing outcomes.<\/jats:p>","DOI":"10.3390\/cancers18071160","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:19:32Z","timestamp":1775434772000},"page":"1160","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Effectiveness of Pomalidomide-Based Regimens in Relapsed\/Refractory Multiple Myeloma: A Multicenter Real-World Analysis in China"],"prefix":"10.3390","volume":"18","author":[{"given":"Shan","family":"Gao","sequence":"first","affiliation":[{"name":"Hematology Department, Beijing Jishuitan Hospital, Capital Medical University, Xicheng District, Beijing 100035, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junling","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Hematology Department, Peking Union Medical College Hospital, Beijing 100023, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aijun","family":"Liu","sequence":"additional","affiliation":[{"name":"Hematology Department, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dongmei","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology Department, Hengshui People\u2019s Hospital, Hengshui 053000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology Department, The Affiliated Hospital of Qingdao University, Qingdao 266005, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Li","sequence":"additional","affiliation":[{"name":"Hematology Department, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihong","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology Department, Fuzhou University Affiliated Provincial Hospital, Fuzhou 350001, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meiyun","family":"Fang","sequence":"additional","affiliation":[{"name":"Hematology Department, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Gong","sequence":"additional","affiliation":[{"name":"Hematology Department, China-Japan Friendship Hospital, Beijing 100029, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhilin","family":"Jia","sequence":"additional","affiliation":[{"name":"Hematology Department, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sun","family":"Wu","sequence":"additional","affiliation":[{"name":"Hematology Department, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453199, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Hematology Department, Xinyang Central Hospital, Xinyang 464099, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genjie","family":"Wang","sequence":"additional","affiliation":[{"name":"Hematology Department, The First People\u2019s Hospital of Shangqiu City, Shangqiu 476100, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-1492","authenticated-orcid":false,"given":"Li","family":"Bao","sequence":"additional","affiliation":[{"name":"Hematology Department, Beijing Jishuitan Hospital, Capital Medical University, Xicheng District, Beijing 100035, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1002\/ajh.25117","article-title":"Multiple myeloma: 2018 update on diagnosis, risk-stratification, and management","volume":"93","author":"Rajkumar","year":"2018","journal-title":"Am. J. Hematol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1001\/jama.2022.0003","article-title":"Diagnosis and Management of Multiple Myeloma: A Review","volume":"327","author":"Cowan","year":"2022","journal-title":"JAMA"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1007\/s40265-017-0689-1","article-title":"Immunomodulatory Drugs in Multiple Myeloma: Mechanisms of Action and Clinical Experience","volume":"77","author":"Holstein","year":"2017","journal-title":"Drugs"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.clml.2023.07.010","article-title":"A Meta-Analysis of the Efficacy of Pomalidomide-Based Regimens for the Treatment of Relapsed\/Refractory Multiple Myeloma After Lenalidomide Exposure","volume":"23","author":"Davies","year":"2023","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.clml.2024.07.014","article-title":"Pomalidomide\/Daratumumab\/Dexamethasone in Relapsed or Refractory Multiple Myeloma: Final Overall Survival from MM-014","volume":"24","author":"Bahlis","year":"2024","journal-title":"Clin. Lymphoma Myeloma Leuk."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e786","DOI":"10.1097\/HS9.0000000000000786","article-title":"Carfilzomib, Pomalidomide, and Dexamethasone As Second-line Therapy for Lenalidomide-refractory Multiple Myeloma","volume":"6","author":"Sonneveld","year":"2022","journal-title":"Hemasphere"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1080\/10428194.2022.2030477","article-title":"Pomalidomide, dexamethasone, and daratumumab immediately after lenalidomide-based treatment in patients with multiple myeloma: Updated efficacy, safety, and health-related quality of life results from the phase 2 MM-014 trial","volume":"63","author":"Bahlis","year":"2022","journal-title":"Leuk. Lymphoma"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e813","DOI":"10.1016\/S2352-3026(23)00218-1","article-title":"Subcutaneous daratumumab plus pomalidomide and dexamethasone versus pomalidomide and dexamethasone in patients with relapsed or refractory multiple myeloma (APOLLO): Extended follow up of an open-label, randomised, multicentre, phase 3 trial","volume":"10","author":"Dimopoulos","year":"2023","journal-title":"Lancet Haematol."},{"key":"ref_9","unstructured":"Network NCC (NCCN Clinical Practice Guidelines in Oncology: Multiple Myeloma, 2025). NCCN Clinical Practice Guidelines in Oncology: Multiple Myeloma, Version 2.2026."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e538","DOI":"10.1016\/S1470-2045(14)70442-5","article-title":"International Myeloma Working Group updated criteria for the diagnosis of multiple myeloma","volume":"15","author":"Rajkumar","year":"2014","journal-title":"Lancet Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Ito, S. (2020). Proteasome Inhibitors for the Treatment of Multiple Myeloma. Cancers, 12.","DOI":"10.3390\/cancers12020265"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1467","DOI":"10.1038\/sj.leu.2404284","article-title":"International uniform response criteria for multiple myeloma","volume":"20","author":"Durie","year":"2006","journal-title":"Leukemia"},{"key":"ref_13","unstructured":"U.S. Department of Health and Human Services NioH, and National Cancer Institute (Common Terminology Criteria for Adverse Events (CTCAE), 2017). Common Terminology Criteria for Adverse Events (CTCAE), Version 5.0."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2955","DOI":"10.1182\/blood-2016-01-631200","article-title":"Treatment of multiple myeloma with high-risk cytogenetics: A consensus of the International Myeloma Working Group","volume":"127","author":"Sonneveld","year":"2016","journal-title":"Blood"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e602","DOI":"10.3324\/haematol.2017.186924","article-title":"Treatment optimization for multiple myeloma: Schedule-dependent synergistic cytotoxicity of pomalidomide and carfilzomib in in vitro and ex vivo models","volume":"103","author":"Borsi","year":"2018","journal-title":"Haematologica"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"798","DOI":"10.1111\/bjh.13780","article-title":"Synergistic anti-myeloma activity of the proteasome inhibitor marizomib and the IM iD\u00ae immunomodulatory drug pomalidomide","volume":"171","author":"Das","year":"2015","journal-title":"Br. J. Haematol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1934","DOI":"10.1182\/blood-2018-99-118829","article-title":"Mechanistic insights of pomalidomide activity in combination with bortezomib and dexamethasone in multiple myeloma and immune cells","volume":"132","author":"Katz","year":"2018","journal-title":"Blood"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1111\/ejh.14365","article-title":"Pomalidomide, Bortezomib, and Dexamethasone Versus Bortezomib and Dexamethasone in Relapsed or Refractory Multiple Myeloma: Final Survival and Subgroup Analyses From the OPTIMISMM Trial","volume":"114","author":"Richardson","year":"2025","journal-title":"Eur. J. Haematol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1722","DOI":"10.1038\/s41375-020-01021-3","article-title":"Pomalidomide, bortezomib, and dexamethasone for multiple myeloma previously treated with lenalidomide (OPTIMISMM): Outcomes by prior treatment at first relapse","volume":"35","author":"Dimopoulos","year":"2021","journal-title":"Leukemia"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1002\/ajh.26361","article-title":"A phase I\/II study of ixazomib, pomalidomide, and dexamethasone for lenalidomide and proteasome inhibitor refractory multiple myeloma (Alliance A061202)","volume":"96","author":"Voorhees","year":"2021","journal-title":"Am. J. Hematol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5039","DOI":"10.1182\/bloodadvances.2024013623","article-title":"Alliance A061202: Ixazomib, pomalidomide, and dexamethasone for patients with lenalidomide-refractory MM in first relapse","volume":"8","author":"Voorhees","year":"2024","journal-title":"Blood Adv."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1080\/10428194.2024.2322030","article-title":"An open-label phase 2 study treating patients with first or second relapse of multiple myeloma with carfilzomib, pomalidomide, and dexamethasone (KPd): SELECT study","volume":"65","author":"Perrot","year":"2024","journal-title":"Leuk. Lymphoma"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"3351","DOI":"10.21037\/tcr-2024-2688","article-title":"Carfilzomib plus pomalidomide and dexamethasone as salvage therapy in patients with relapsed or refractory multiple myeloma in China: A retrospective study","volume":"14","author":"Xiao","year":"2025","journal-title":"Transl. Cancer Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"7032","DOI":"10.1182\/blood-2024-207159","article-title":"Real-World Effectiveness and Safety Analysis of Carfilzomib-Pomalidomide-Dexamethasone in Relapsed\/Refractory Multiple Myeloma: A Multicenter Retrospective Study from Eastern Shandong of China","volume":"144","author":"Fan","year":"2024","journal-title":"Blood"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1182\/blood-2021-149423","article-title":"Carfilzomib, pomalidomide and dexamethasone (KPd) in patients with first progression of multiple myeloma refractory to bortezomib and lenalidomide. Final report of the EMN011\/HOVON114 trial","volume":"138","author":"Sonneveld","year":"2021","journal-title":"Blood"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e7232","DOI":"10.1002\/cam4.7232","article-title":"Clinical outcomes of pomalidomide-based and daratumumab-based therapies in patients with relapsed\/refractory multiple myeloma: A real-world cohort study in China","volume":"13","author":"Han","year":"2024","journal-title":"Cancer Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1111\/bjh.18172","article-title":"Outcomes of daratumumab in the treatment of multiple myeloma: A retrospective cohort study from the Canadian Myeloma Research Group Database","volume":"198","author":"LeBlanc","year":"2022","journal-title":"Br. J. Haematol."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Atrash, S., Thompson-Leduc, P., Tai, M.-H., Kaila, S., Gray, K., Ghelerter, I., Lafeuille, M.-H., Lefebvre, P., and Rossi, A. (2021). Treatment patterns and effectiveness of patients with multiple myeloma initiating daratumumab across different lines of therapy: A real-world chart review study. BMC Cancer, 21.","DOI":"10.1186\/s12885-021-08881-7"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3286","DOI":"10.1038\/s41375-020-0813-1","article-title":"Pomalidomide, dexamethasone, and daratumumab in relapsed refractory multiple myeloma after lenalidomide treatment","volume":"34","author":"Siegel","year":"2020","journal-title":"Leukemia"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/bjh.14547","article-title":"Real-world use of pomalidomide and dexamethasone in double refractory multiple myeloma suggests benefit in renal impairment and adverse genetics: A multi-centre UK experience","volume":"176","author":"Maciocia","year":"2017","journal-title":"Br. J. Haematol."},{"key":"ref_31","first-page":"974","article-title":"Daratumumab plus pomalidomide and dexamethasone in relapsed and\/or refractory multiple myeloma","volume":"130","author":"Chari","year":"2017","journal-title":"Blood J. Am. Soc. Hematol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/7\/1160\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T00:29:16Z","timestamp":1775435356000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/18\/7\/1160"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,3]]},"references-count":31,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["cancers18071160"],"URL":"https:\/\/doi.org\/10.3390\/cancers18071160","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,3]]}}}