Carfilzomib improves outcome in patients with refractory multiple myeloma

This paper studied the use of carfilzomib (Kyprolis) in high-risk patients with multiple myeloma. This study concluded that carfilzomib improved survival and response to treatment. 

Multiple myeloma is a cancer of the plasma cells (type of white blood cell). Following treatment, many patients relapse (have a return of cancer). Studies have found that certain genetic abnormalities increase the risk of a worse outcome. Patients with these “high-risk” genetic abnormalities have a worse survival. These abnormalities include translocation (4;14), translocation (14;16), and deletion (17p).

It is not clear how these genetic abnormalities affect outcomes with newer treatment options. Carfilzomib is a drug used in the treatment of multiple myeloma that has not responded to treatment. Previous studies have suggested that a combination of carfilzomib, lenalidomide (Revlimid) and dexamethasone was more effective than lenalidomide and dexamethasone alone. It is not clear if this is true in patients with high-risk disease.

417 patients with relapsed multiple myeloma were studied. They were classified into “high risk” and “standard risk” based on their genes. Of 100 “high risk” patients, 48 received carfilzomib, lenalidomide, and dexamethasone while 52 received lenalidomide and dexamethasone. Of 317 “standard risk” patients, 147 received carfilzomib, lenalidomide, and dexamethasone, while 170 received lenalidomide and dexamethasone.

The average period of survival without worsening disease was 23.1 months for “high risk” patients who received carfilzomib and 13.9 months for “high risk” patients who did not receive carfilzomib. The average period of survival without worsening disease was 29.6 months for “standard risk” patients who received carfilzomib and 19.5 months for “standard risk” patients who did not receive carfilzomib.

The overall response rate among “high risk” patients was 79.2% among those who received carfilzomib and 59.6% among those who did not receive carfilzomib. The overall response rate among “standard risk” patients was 91.2% with carfilzomib and 73.5% without.  

The authors concluded that the addition of carfilzomib improved overall outcome in relapsed multiple myeloma, regardless of the underlying genetic risk. 

Talk to your doctor about receiving carfilzomib.