In a nutshell
This study investigated the cardiovascular (heart and blood vessels) safety of carfilzomib (Kyprolis) in patients with relapsed or refractory (does not respond to treatment) multiple myeloma. This study concluded that the benefits of carfilzomib outweighed its risks.
Some background
Multiple myeloma is a type of cancer of the bone marrow that can lead to abnormal immune cells. Patients with multiple myeloma may be at a higher risk for cardiovascular events. This risk can be due to age, additional diseases, or side effects from cancer therapy.
Carfilzomib is a targeted therapy used in patients with multiple myeloma. This type of treatment only targets cancer cells, without damaging normal cells. This leads to cancer cell death with fewer side effects. Whether carfilzomib is associated with significant cardiovascular side effects in patients with multiple myeloma remains under investigation.
Methods & findings
Overall, this study analyzed the results of 11 studies comparing the cardiovascular safety of carfilzomib to other treatments (control group) in patients with relapsed or refractory multiple myeloma. Patients in the carfilzomib group received carfilzomib alone, or with other drugs. Patients in the control group received best supportive care or drug combinations without carfilzomib.
In one analysis, 2044 patients with relapsed or refractory multiple myeloma treated with carfilzomib were analyzed. For all patients, the most common side effects included high blood pressure (18.5%), shortness of breath (31.9%), and heart failure (6.7%). More severe cardiovascular side effects were experienced by 5.9% (high blood pressure), 4.5% (shortness of breath) and 4.4% (heart failure) of patients.
A separate analysis compared 1012 patients in the carfilzomib group and 998 patients in the control group. 2.67% of the patients in the carfilzomib group and 2% in the control group stopped treatment due to side effects. However, in two of the studies analyzed, patients in the carfilzomib group had a lower risk of disease progression or death 18 months after starting treatment compared to the control group (35% vs 52% in the first study and 48% vs 78% in the second study).
The bottom line
This study concluded that the benefits of carfilzomib outweighed the risks of developing heart failure or hypertension in most patients. The authors suggested that patients with cardiovascular risk factors should be closely monitored during treatment, especially those who are elderly.
The fine print
This study received support from Onyx Pharmaceuticals, the developer of carfilzomib.
Published By :
Blood advances
Date :
Jul 10, 2018
