Efficacy and Safety of Carfilzomib-Based Regiments for the Treatment of Relapsed or Refractory Multiple Myeloma: Single-Center Real-Word Data

Introduction:

Carfilzomib has been approved for the treatment of relapsed or refractory multiple myeloma (RRMM) in China¹ and become a new trend for the treatment of RRMM in clinical practice. In this study, we retrospectively analyzed the clinical data of 60 RRMM patients in real world to investigate the clinical efficacy and safety of carfilzomib-based therapies, with a view to further optimizing the treatment of RRMM.

Methods:

we retrospectively collected and analyzed clinical data of 60 RRMM patients treated with carfilzomib based chemotherapy regimens in the Hematology Department of the Second Affiliated Hospital of Harbin Medical University from January 2023 to June 2024. The efficacy was evaluated at the end of each cycle of treatment, and the adverse effects were recorded in detail during the treatment process. The primary endpoint is Overall Response Rate (ORR), while the secondary endpoints are Overall Survival (OS) and Progress Free Survival (PFS) according to 2016 IMWG criteria.

Results:

Sixty RRMM were available for efficacy and safety assessment. Carfilzomib based therapies includes KRd (carfilzomib, lenalidomide and dexamethasone; 8 cases), KCd (carfilzomib, cyclophosphamide, and dexamethasone; 10 cases), DKd (carfilzomib, daratumumab, and dexamethasone; 8 cases), KPd(carfilzomib, pomalidomide, and dexamethasone; 8 cases), KBd (carfilzomib, bendamustine, cyclophosphamide, and dexamethasone; 4 cases), KDD(carfilzomib, dexamethasone and liposomal doxorubicin; 4 cases) and Kd (carfilzomib and dexamethasone; 20 cases). The median number of cycles was 4 (2-9). The ORR was 83.3%(50/60) of which 6 (10.0%) complete response (CR) in 6 cases, 10 (16.7%) very good partial response (VGPR) , and 34 (56.7%) partial response (PR). Patients of older than 60 years old, R-ISS stage III, high-risk cytogenetic abnormalities, and previous ≥3 lines of therapy account for 60%, 73.3%, 63.3%, and 26.7% respectively. The ORR was significantly lower in patients who previously had received third-line and higher treatment (50%) than in those who had received first- and second-line treatment(95.5%, p＜0.05). Median PFS was 8 months and the data of OS was unmature. The most common hematological and non-hematological adverse effects were thrombocytopenia (50.0%) and upper respiratory tract infection (30%) respectively which were resolved or relieved in vast majority of patients after symptomatic treatment without affecting the course of treatment.

Conclusion:

The efficacy of carfilzomib-based regimens in RRMM is promising and adverse effects are manageable.

References：

1.Carfilzomib (Kyprolis®) label.

No relevant conflicts of interest to declare.