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Carfilzomib, lenalidomide, and dexamethasone in patients with RRMM: Real‑world evidence
Garcia-Guiñon et al. conducted a retrospective, observational study to evaluate the effectiveness and safety of KRd in patients with RRMM treated according to standard hospital clinical practice in the Catalan region (Spain). In total, 194 patients were included, with a median age of 64 years. All patients had received bortezomib, 46% of patients had received thalidomide, and 15% had received lenalidomide. The cohort included patients with high cytogenetic risk (20% of those assessed for cytogenetic risk) and renal impairment. The primary endpoint was ORR according to IMWG criteria. Secondary endpoints included PFS and OS. Findings were published in Annals of Hematology.
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Key learnings1 |
The ORR was 73%, with 37% of patients achieving ≥ CR (11% sCR) and 52% achieving ≥ VGPR. The median PFS was 26 months, with a median 12-month PFS rate of 64%. The median OS was 65 months, with a 2-year OS rate of 70%. |
ORR was influenced by ISS, with a higher ORR (86%) observed in patients with ISS Stage I vs Stages II or III. Response rates were maintained across subgroups, including elderly patients; those with high cytogenetic risk, extramedullary disease, or renal impairment; and patients with hemoglobin levels ≥10 mg/dL. |
TEAEs were reported in 71% of patients, with Grade ≥3 TEAEs in 38%. Hematologic toxicities were the most common TEAEs, including anemia (35%), leukopenia (33%), and thrombocytopenia (29%); most of which were Grade ≥3 (29%, 22%, and 22%, respectively). |
KRd demonstrated good effectiveness, despite inclusion of higher-risk patients, with safety data comparable with phase III trials. KRd may offer a second- or third-line treatment option regardless of age or renal functioning, especially for patients progressing to T-cell based therapies, and as bridging to SCT. |
Abbreviations: AE, adverse event; CR, complete response; IMWG, International Myeloma Working Group; ISS, injury severity score; KRd, carfilzomib, lenalidomide, and dexamethasone; ORR, overall response rate; OS, overall survival; PFS, progression-free survival; RRMM, relapsed/refractory multiple myeloma; sCR, stringent complete response; SCT, stem cell transplant; TEAE, treatment emergent adverse event; VGPR, very good partial response.
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