Fredrik Schjesvold, MD, PhD, Discusses the Safety Profile of Melflufen/Dexamethasone in Relapsed/Refractory Multiple Myeloma

CancerNetwork® sat down with Fredrik Schjesvold, MD, PhD, at the 2021 International Myeloma Workshop to discuss the differences in safety profiles between melflufen/dexamethasone and pomalidomide/dexamethasone in relapsed/refractory multiple myeloma.

At the 2021 International Myeloma Workshop, CancerNetwork® spoke with Fredrik Schjesvold, MD, PhD, founder and head of the Oslo Myeloma Center, about the differences in safety profile between melflufen (Pepaxto)/dexamethasone and pomalidomide (Pomalyst)/dexamethasone, as seen in the phase 3 OCEAN trial (NCT03151811).


[Regarding the safety profile], there were differences, mainly in cytopenias where there were more cytopenias of all kinds for melflufen. [However], there were more infections in the pomalidomide arm. It seems that an increase in neutropenia doesn’t give any more infections. The safety problem for melflufen is in patients who are transplanted, who seem to have prolonged cytopenia after the treatment [with] melflufen, which probably makes them less tolerant of further treatment. That’s what's adding onto the survival detriment in the patients who are transplanted from before, because it seems like it's the patients who are transplanted from before who do get this prolonged bone marrow suppression from melflufen and we don’t see that in non-transplanted patients. Safety wise, as long as the treatment was ongoing, there were no big signals. The problem is after the treatment is over, [and patients] move on to the next treatment [and] you see that transplant in patients. Plus melflufen gives a longer-term problem.


Schjesvold F, Dimopoulos MA, Delimpasi S, et al. OCEAN (OP-103): a Phase 3, randomized, global, head-to-head comparison study of melflufen and dexamethasone (Dex) versus pomalidomide (Pom) and dex in relapsed refractory multiple myeloma (RRMM). Presented at: International Myeloma Workshop; September 8-11, 2021; Vienna, Austria. Accessed September 11, 2021.