Carfilzomib-Dexamethasone Efficacy and Toxicity in Multiple Myeloma

Researchers examined real-world data to assess the efficacy and toxicity of weekly carfilzomib at a dose of 70 mg/m² plus dexamethasone (Kd70) in patients with relapsed or refractory multiple myeloma (MM).

Presented at the Society of Hematologic Oncology 2024 Annual Meeting in Houston, Texas, the retrospective analysis included patients in a tertiary center between 2018 and 2023 who “received at least one cycle of Kd70 (carfilzomib 70 mg/m² on days 1, 8, and 15, plus weekly dexamethasone 40 mg on a 21-day cycle).” It did not include patients who received carfilzomib outside of Kd70.

A total of 25 patients were selected: 10 women and 15 men. Their median age was 56. Of those, 10 were still on the Kd70 regimen at the time of data cutoff, whereas 15 had discontinued. The analysis stated that 64% of patients began Kd70 as a fourth or later line of therapy, noting “10 patients discontinued Kd70 in the first six months of therapy due to progression or toxicity.”

Of the 15 patients with evaluable responses, the overall response rate was 70.5%. The study highlighted the following results: “Nine patients had very good partial response, three had partial response, and one patient had stable disease as best response. There were no grade 3 or higher hematologic toxicities. Fourteen patients (56%) had grade 1 thrombocytopenia, and nine (36%) had grade 1 anemia. The incidence of non-hematologic toxicities was 92%, but mostly low grade.” The most common adverse events were pneumonia, nausea, and emesis.

Study authors initially noted that prior research indicated “strong evidence” that weekly Kd70 can increase progression-free survival (PFS). The results of this retrospective analysis showed a median PFS of 9.5 months and three-year overall survival of 68%, over a median follow-up of 36 months.

The authors concluded that Kd70 has efficacy and an “acceptable toxicity profile” in patients with relapsed or refractory MM, “even after multiple prior lines of therapy.” However, they noted that regarding the efficacy of weekly Kd70 in earlier lines, additional analysis would be needed.

Reference

Mengüç M, Günhan H, Şişman İ, et al. Retrospective analysis of a weekly carfilzomib-dexamethasone regimen in relapsed/refractory multiple myeloma: single center experience. Abstract #MM-174. Presented at the Society of Hematologic Oncology 2024 Annual Meeting; September 4-7, 2024; Houston, Texas.