Carfilzomib Shows Benefits Over Bortezomib in Triplet Induction Therapy for Multiple Myeloma

Induction therapy with lenalidomide and dexamethasone plus carfilzomib (KRd) was associated with improved progression-free survival (PFS) and event-free survival (EFS) compared with lenalidomide and dexamethasone plus bortezomib (VRd) in patients with newly diagnosed multiple myeloma (MM), according to a single-center, retrospective analysis.

The study also reported a trend toward improved overall survival (OS) with KRd versus VRd. Overall, the improvements were “primarily driven by improvements in outcome for high-risk patients,” stated lead author Carlyn Rose Tan, MD, and colleagues from the Memorial Sloan Kettering Cancer Center in New York. Data were presented in Research Square.

The study reviewed 389 standard- or high-risk patients with newly diagnosed MM, of whom 198 received VRd and 191 received KRd. Authors reported that median PFS was not reached (NR) in either group. They estimated the following survival rates at five years for each treatment group.

In the standard-risk patient subgroup, five-year PFS was 68% (95% CI, 60-78) with VRd and 75% (95% CI, 65-85) with KRd (P=.20), and five-year OS was 87% (95% CI,81-94) with VRd versus 93% (95% CI, 87-99) with KRd (P=.13).

For high-risk patients, the median PFS was 41.0 months (95% CI, 32.8-61.1) with VRd and 70.9 months (95% CI, 58.2-NR) with KRd (P=.016), and corresponding five-year PFS and OS rates were 35% (95% CI, 24-51) and 69% (95% CI, 58-82) with VRd, respectively, versus 58% (95% CI, 47-71) and 88% (95% CI, 80-97) with KRd, respectively.

In closing, the author suggested their findings “provide clinically important information for treating physicians and patients with newly diagnosed multiple myeloma.”

Reference

Tan CR, Derkach A, Nemirovsky D, et al. Bortezomib, lenalidomide and dexamethasone (VRd) vs carfilzomib, lenalidomide and dexamethasone (KRd) as induction therapy in newly diagnosed multiple myeloma. Preprint. Res Sq. 2023. doi:10.21203/rs.3.rs-2583053/v1