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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.

Authors :
Rocchi S
Tacchetti P
Pantani L
Mancuso K
Rizzello I
di Giovanni Bezzi C
Scalese M
Dozza L
Marzocchi G
Martello M
Barilà G
Antonioli E
Staderini M
Buda G
Petrini M
Cea M
Quaresima M
Furlan A
Bonalumi A
Cavo M
Zamagni E
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.)

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