2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:Tb20,Abstract Patients with multiple myeloma bearing a deletion of chromosome 17p (del(17p)), mutation of TP53 , or both have poorer prognosis compared to patients without these aberrations. We investigated the activity and mechanism of melflufen (melphalan flufenamide) in myeloma models with wild type TP53 ( TP53 wt) and complete TP53 deletion ( TP53 −/− ) and assessed the efficacy of melflufen in patients with del(17p) and/or TP53 mutation. Ex vivo data from myeloma plasma cells (PC) showed comparable activity of melflufen in del(17p), TP53 −/− , and TP53 wt samples. scRNAseq data demonstrated that melflufen sensitive PCs had lower expression of p53 target genes and higher expression of genes associated with DNA damage repair and cell cycle checkpoints. Irrespective of TP53 status, melflufen induced apoptosis, DNA damage, and mitochondrial dysfunction, while only in TP53 −/− cells, it led to changes in expression of cell cycle checkpoint and apoptosis genes. Post-hoc analysis of the OCEAN trial melflufen-treated del(17p) patient population also demonstrated favorable progression free survival compared to pomalidomide-treated cohort. Our insights into the molecular mechanisms of melflufen activity in TP53 −/− myeloma support its clinical efficacy and application in the del(17p) and TP53 −/− patient population. Trial registration NCT03151811, registration 2017-05-09. 31:T561,K.A., Y.D., K.W.M., J.O., S.S.G. are employees of and receives stock or stock options from Oncopeptides. S.N. is an employee of, has participated on a data safety monitoring board or advisory board for, and receives stock or stock options from Oncopeptides. M.T. is a consultant of and receives stock or stock options from Oncopeptides. A.S., F.L., are former employees of and receive stock or stock options from Oncopeptides. F.S. has received grants or contracts from Celgene, GlaxoSmithKline, Janssen, Oncopeptides, Targovax, and Sanofi; payment or honoraria for lectures or speakers’ bureau participation from AbbVie, Amgen, Bristol Myers Squibb, Daiichi Sankyo, GlaxoSmithKline, Janssen, Novartis, Oncopeptides, Pfizer, Sanofi, SkyliteDX, and Takeda; serving on a data safety monitoring or advisory board for AbbVie, Celgene, GlaxoSmithKline, Janssen, Oncopeptides, Sanofi, and Takeda; and stock or stock options from Nordic Nanovector. P.So. has received grants or contracts from Amgen, Celgene, Janssen, Takeda, and SkylineDx. C.A.H. has received research funding from Oncopeptides related to this work, and from IMI2 projects HARMONY and HARMONY PLUS, WntResearch, Orion, Kronos Bio, Novartis, Celgene, Zentalis Pharmaceuticals for unrelated work, plus honoraria or personal fees from Amgen and Autolus. The remaining authors declare no competing financial interests.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"melphalan flufenamide: generic Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on melphalan flufenamide (generic). Clinician-written summaries and actionable practice insights. 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Elimination half-life increased slightly with worsening renal function (89.1–109.6 min). TEAEs occurred in 34/35 patients; 6 patients died due to a TEAE.","limitations":"Very small cohort sizes (especially Cohort 2a, n=4) limit conclusions for severe RI. Only 3 post-infusion PK time points per cycle were collected, which may reduce PK model precision. No comparator arm with normal renal function was included within the study.","practice_takeaway":"For RRMM patients with moderate renal impairment, PK data support a melflufen dose of 30 mg (rather than 40 mg). No new safety signals were identified in patients with moderate-to-severe renal impairment, but the high TEAE mortality rate (6/35) warrants close monitoring."}},{"doi":"10.1186/s40164-025-00729-1","pmid":"41437395","title":"Efficacy of melflufen in multiple myeloma with mutated or deleted TP53","journal_title":"Experimental Hematology & Oncology","journal_issn":"2162-3619","published_at":"2025-12-24T00:00:00.000Z","url":"https://doi.org/10.1186/s40164-025-00729-1","source_score":33,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2025-12-25","doi":"10.1186/s40164-025-00729-1","days":"30","issn":"2162-3619","rank":"10","field":"Clinical Medicine","score":"33","category":"Hematology","categories":["Hematology"],"_categories":["Hematology"]},"pubmed":{"doi":"10.1186/s40164-025-00729-1","title":"Efficacy of melflufen in multiple myeloma with mutated or deleted TP53.","journal":"Experimental hematology & oncology","methods":"","results":"","abstract":"Patients with multiple myeloma bearing a deletion of chromosome 17p (del(17p)), mutation of TP53, or both have poorer prognosis compared to patients without these aberrations. 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latest HUS study permit HUS/395/2018 dated 13 February 2018; Permit numbers 239/13/03/00/2010, 303/13/03/01/2011) and in accordance with the Declaration of Helsinki."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"},"order":3,"value":"Not applicable."},{"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"},"order":4,"value":"$31"}],"deposited":{"date-time":"2025-12-23T13:25:49Z","timestamp":1766496349000,"date-parts":[[2025,12,23]]},"issn-type":[{"type":"electronic","value":"2162-3619"}],"published":{"date-parts":[[2025,12,23]]},"publisher":"Springer Science and Business Media LLC","reference":[{"DOI":"10.3390/ijms21010013","key":"729_CR1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":"Ho T, Tan BX, Lane D. 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