FDA warns about increased risk of death associated with Melphalan flufenamide

[FDA MedWatch, July 28, 2021] – The U.S. FDA is alerting patients and health care professionals that a clinical trial (OCEAN, Study OP-103) evaluating Pepaxto (melphalan flufenamide) with dexamethasone to treat patients with multiple myeloma showed an increased risk of death. 

The trial compared Melphalan with low-dose Dexamethasone to Pomalidomide with low-dose Dexamethasone in patients with relapsed or refractory (resistant) multiple myeloma following 2-4 lines of prior therapy and in patients who were resistant to Lenalidomide in the last line of therapy.

FDA approved Melphalan in February 2021, for use in combination with Dexamethasone to treat adult patients with relapsed or refractory multiple myeloma who have received at least four prior lines of therapy and whose disease was refractory to at least one proteasome inhibitor, one immunomodulatory agent, and one CD38-directed monoclonal antibody.

RECOMMENDATIONS: 

  • FDA encourages health care professionals to review patients’ progress on Melphalan and discuss the risks of continued administration with each patient in the context of other treatments.
  • Patients currently receiving Melphalan should also discuss with their health care professional the risks and benefits of receiving Melphalan.

Source:

FDA CDER Alert, July 28, 2021

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