In a nutshell
The study compared outcomes of once-weekly (OW) versus twice-weekly (TW) carfilzomib (Kyprolis) plus dexamethasone (Decadron) in Japanese patients with relapsed/refractory (RR) multiple myeloma (MM). The authors found that the OW dosage improved overall response rate (ORR) compared to TW in such patients.
Some background
RR-MM is when MM stops responding to treatment or returns after therapy. Carfilzomib in combination with dexamethasone (Kd) is currently used to treat RR-MM. It is administered OW (20/70 mg/m2) or TW (20/56 mg/m2) as a 30 minutes infusion. Previous studies have shown that both dosages improve survival in patients with RR-MM. However, there was no comparison between Kd 20/70 OW vs 20/56 TW in these patients.
Methods & findings
The study included patients with RR-MM from 2 studies. Study 1 included 40 adult Japanese patients. 26 patients received 20/70 OW-Kd and 14 received 20/27 TW-Kd. The average treatment duration was 43.6 weeks for OW-Kd and 40.1 weeks for TW-Kd. Study 2 included patients treated with 20/56 TW-Kd.
In study 1, the average survival without cancer progression was 14.8 months for 20/70 OW-Kd and 9.7 months for 20/27 TW-Kd. 20/70 OW-Kd had a 45.8% lower risk of progression or death compared to 20/27 TW-Kd. The ORR was 73.1% for 20/70 OW-Kd and 57.1% for 20/27 TW-Kd.
All patients in both groups experienced side effects. Severe side effects occurred in 80.8% of patients in the 20/70 OW-Kd group and 78.6% in the 20/27 TW-Kd group. Acute lung injury and fluid build-up in the lungs occurred in 2 patients from the OW-Kd group.
A comparison was made between the 2 studies. The ORR in patients treated with 20/70 OW-Kd was 73.1% compared to 42.9% for 20/56 TW-Kd.
The bottom line
The study concluded that 20/70 OW-Kd improved ORR compared to 20/27 and 20/56 TW-Kd in patients with RR-MM.
The fine print
This study only included Japanese patients. Also, the results compared 2 different studies with different protocols. Further direct studies are needed to confirm these findings.
Published By :
International journal of hematology
Date :
Oct 10, 2020
