New Protocol: Venetoclax with Dexamethasone for Rel/Ref Myeloma with t(11;14)

In the CANOVA study, venetoclax-dexamethasone did not significantly improve progression-free survival compared to pomalidomide-dexamethasone in patients with t(11;14)-positive relapsed/refractory multiple myeloma. However, overall response rate was higher in the venetoclax-dexamethasone group. Neutropenia was more common in the pomalidomide-dexamethasone arm.

  • Study

    Randomized, open-label, phase III study [CANOVA; NCT03539744]
    t(11;14)-positive relapsed/refractory multiple myeloma with >=2 previous therapies
    Venetoclax-dexamethasone (n=133) vs pomalidomide-dexamethasone (n=130) until progression or toxicity



  • Efficacy

    ORR: 62% vs 35% (venetoclax vs. pomalidomide)
    Median PFS: 9.9 mos vs 5.8 mos (HR 0.823 [0.596-1.136])
    Median OS: 32.4 mos vs 26.9 mos (HR 0.856 [0.612-1.197])
    MRD negativity: 8% vs 0%



  • Safety

    Grade >=3 AE: treatment-emergent adverse events (67% vs 83%), neutropenia (19% vs 54%)
    Serious AEs: pneumonia (most common)
    Treatment-emergent deaths: 12% vs 6%


  • J Clin Oncol 2025;44:164-175

    Popat R, Beksac M, Dimopoulos MA Venetoclax-Dexamethasone Versus Pomalidomide-Dexamethasone in t(11;14)-Positive Relapsed/Refractory Multiple Myeloma: Primary Results of the Randomized, Phase III CANOVA Study

    http://doi.org/10.1200/JCO-25-00924

    Reviewed by Ulas D. Bayraktar, MD on Jan 21, 2026

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