Carfilzomib regimen effective in newly diagnosed, transplant-eligible multiple myeloma

  • Wester R & al.
  • Haematologica
  • 4 Apr 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Induction and consolidation therapy with carfilzomib, thalidomide, and low-dose dexamethasone (KTd) is effective with manageable toxicity in transplant-eligible patients with newly diagnosed multiple myeloma (NDMM),

Why this matters

  • Carfilzomib is currently approved for the treatment of relapsed and/or refractory multiple myeloma.
  • This is the first study of KTd induction and consolidation in this setting.

Study design

  • Phase 2 Carthadex study to investigate KTd induction and consolidation in 111 patients with transplant-eligible NDMM.
  • Induction was followed by high-dose melphalan and autologous stem cell transplantation.
  • 4 doses were studied; overall results are summarized.
  • Funding: Onyx Pharmaceuticals, Inc.   

Key results

  • Responses after induction:
    • 93% overall response rate (ORR).
    • 65% very good partial response (VGPR) rate or better.
    • 18% complete response (CR) rate or better.
  • Responses after consolidation:
    • 94% ORR.
    • 86% VGPR rate or better.
    • 63% CR rate or better.
  • 83 months (95% CI, 83-not reached [NR]) median OS.
  • 58 (95% CI, 45-67) months median PFS.
  • No association between dose level/risk status and OS.
  • 10% of patients experienced grade 3-4 hematological toxicity.
  • The most common grade 3-4 nonhematological toxicities were:
    • Infections: 11%.
    • Respiratory disorders: 8%.
    • Skin disorders: 9%.
    • Vascular disorders: 9%

Limitations

  • Open-label study.

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