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A real-world efficacy and safety analysis of combined carfilzomib, lenalidomide, and dexamethasone (KRd) in relapsed/refractory multiple myeloma.
A real-world efficacy and safety analysis of combined carfilzomib, lenalidomide, and dexamethasone (KRd) in relapsed/refractory multiple myeloma.
- Source :
-
Hematological oncology [Hematol Oncol] 2021 Feb; Vol. 39 (1), pp. 41-50. Date of Electronic Publication: 2020 Nov 01. - Publication Year :
- 2021
-
Abstract
- Carfilzomib-lenalidomide-dexamethasone (KRd) has been approved for the treatment of relapsed/refractory multiple myeloma (RRMM). We conducted a retrospective analysis of 197 RRMM patients (pts) between January 2016 and March 2018 in six Italian hematologic centers, with the aim to evaluate efficacy and safety of KRd in real-life. At KRd initiation 27% carried high risk cytogenetic abnormalities (HRCA) [del17p and/or t(4;14) and/or t(14;16)], median number of prior lines of therapy was 2 (1-8), nearly all pts (96%) received prior bortezomib (18% refractory) while 45% were exposed to lenalidomide (R; 22% refractory). At the median of 12.5 months, 52% of the pts had discontinued treatment, mainly (66%) for progression. Main grade 3-4 adverse events were neutropenia (21%), infections (11%), and hypertension (6%). Overall, the response rate was 88%. The median progression-free survival (PFS) was 19.8 months and 1-year overall survival (OS) rate was 80.6%. By subgroup analysis, extended PFS and OS were observed for pts who received ≤2 prior lines of therapy (HR = 0.42, p < 0.001 and HR = 0.35, p = 0.001, respectively), not refractory to prior R (HR = 0.37, p < 0.001, and HR = 0.47, p = 0.024), without HRCA (HR = 0.33, p = 0.005 and HR = 0.26, p = 0.016) and achieving ≥ very good partial response (VGPR; HR = 0.17, p < 0.001 and HR = 0.18, p < 0.001). In conclusion, KRd demonstrated to be effective in RRMM pts treated in real-world setting, without new safety concerns. Better survival outcomes emerged for pts with ≤2 prior lines of therapy, achieving at least a VGPR, and without HRCA.<br /> (© 2020 John Wiley & Sons Ltd.)
- Subjects :
- Aged
Antineoplastic Combined Chemotherapy Protocols adverse effects
Chromosome Aberrations
Dexamethasone administration & dosage
Dexamethasone adverse effects
Disease-Free Survival
Female
Humans
Lenalidomide administration & dosage
Lenalidomide adverse effects
Male
Middle Aged
Multiple Myeloma genetics
Oligopeptides administration & dosage
Oligopeptides adverse effects
Recurrence
Survival Rate
Antineoplastic Combined Chemotherapy Protocols administration & dosage
Multiple Myeloma drug therapy
Multiple Myeloma mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1099-1069
- Volume :
- 39
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Hematological oncology
- Publication Type :
- Academic Journal
- Accession number :
- 33085797
- Full Text :
- https://doi.org/10.1002/hon.2820