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Posted by on Aug 7, 2017 in Multiple Myeloma | 0 comments

In a nutshell

This study examined the safety of combining carfilzomib (Kyprolis), cyclophosphamide (Cytoxan), and dexamethasone Decadron) for multiple myeloma. Researchers reported early results on the safety and potential effectiveness of this treatment combination.

Some background

Advances in first-line treatments have improved response and survival rates among multiple myeloma patients. Carfilzomib is a type of targeted therapy that blocks the action of a protein in cancer cells. Early studies have reported promising results for newly diagnosed multiple myeloma. Cyclophosphamide is a type of chemotherapy used to treat a number of different cancers. It has been suggested that the way these two therapies work could complement each other and therefore improve treatment outcomes when combined.

Methods & findings

The aim of this study was to assess the safety and dosage of this treatment combination.

22 patients with newly diagnosed multiple myeloma were included. All patients were treated with carfilzomib, cyclophosphamide, and dexamethasone (a steroid) for up to 8 cycles. Cyclophosphamide was administered at 300 mg/m2. Dexamethasone was administered at 40 mg. The dose of carfilzomib was gradually increased from 36 mg/m2 to 45 mg/m2 to 56 mg/m2. Patients were followed for an average of 7.2 months.

The response rate was 87.5% when carfilzomib was at 56 mg/m2. The average time to treatment response was 1 month.

No side effects were reported that led to decreasing the dose of any treatment. A total of 16 patients were treated with carfilzomib at 56 mg/m2. Of these, 10 completed all 8 cycles. 5 patients discontinued treatment due to side effects. 1 patient discontinued due to disease progression.

Across all 22 patients, common side effects included nausea (72.7%), low red blood cell levels (40.9%), diarrhea (40.9%), vomiting (40.9%), shortness of breath (36.4%), and fluid retention (31.8%). 25% of patients experienced severe low red blood cell levels. Other serious side effects included low white blood cell counts and kidney injuries. 

The bottom line

Researchers concluded that carfilzomib is effective when combined with cyclophosphamide and dexamethasone. The side effects of this treatment combination are manageable.

The fine print

Further clinical trials are needed to examine this treatment combination. 

This trial was funded by Onyx Pharmaceuticals, which is part of Amgen, the manufacturers of carflizomib.

Published By :

Clinical lymphoma, myeloma & leukemia

Date :

May 10, 2017

Original Title :

A Multicenter, Open-Label, Phase 1b Study of Carfilzomib, Cyclophosphamide, and Dexamethasone in Newly Diagnosed Multiple Myeloma Patients (CHAMPION-2).

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