Carfilzomib in addition to lenalidomide and dexamethasone in Asian patients with RRMM outside of a clinical trial

Ann Hematol. 2021 Aug;100(8):2051-2059. doi: 10.1007/s00277-021-04407-0. Epub 2021 Jan 15.

Abstract

Carfilzomib, lenalidomide, and dexamethasone (KRd) effectively improve survival in patients with relapsed and refractory multiple myeloma (RRMM). However, the outcome of KRd treatment in Asian patients reflecting a general RRMM population outside of a clinical trial has not been reported. Fifty-five RRMM patients who were treated with carfilzomib in combination with Rd from the time of the first approval of KRd in the Republic of Korea were analyzed. The median age was 61 years. The percentage of patients with an ECOG performance status ≥ 3, creatinine clearance < 50 mL/min, high-risk cytogenetics, and ≥ 4 lines of prior treatment were 9%, 22%, 31%, and 27%, respectively. Forty-one patients started treatment with KRd, whereas the remaining 14 patients (25%) were added carfilzomib during the Rd treatment. In the whole cohort, the overall response rate was 73% and progression-free survival was 8.8 months. The addition of carfilzomib in patients who were refractory or had disease progression during Rd treatment reattained a response in half of the patients. The advantage of carfilzomib with Rd was significant in patients in the first relapse. Toxicity profile was acceptable, excluding severe infections. Carfilzomib in combination with Rd is effective and has a reasonable adverse event rate in Asian patients with RRMM.

Keywords: Asia; Carfilzomib; Lenalidomide; Real-world; Relapsed and refractory multiple myeloma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Dexamethasone / adverse effects
  • Dexamethasone / therapeutic use*
  • Disease-Free Survival
  • Female
  • Humans
  • Lenalidomide / adverse effects
  • Lenalidomide / therapeutic use*
  • Male
  • Middle Aged
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / epidemiology
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / epidemiology
  • Oligopeptides / adverse effects
  • Oligopeptides / therapeutic use*
  • Progression-Free Survival
  • Republic of Korea / epidemiology

Substances

  • Antineoplastic Agents
  • Oligopeptides
  • carfilzomib
  • Dexamethasone
  • Lenalidomide