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Title: Real-world effectiveness and safety analysis of carfilzomib-lenalidomide-dexamethasone and carfilzomib-dexamethasone in relapsed/refractory multiple myeloma: a multicenter retrospective analysis
Authors: Onda, Yoshiyuki
Kanda, Junya  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-6704-3633 (unconfirmed)
Kaneko, Hitomi
Shimura, Yuji
Fuchida, Shin-Ichi
Nakaya, Aya
Itou, Tomoki
Yamamura, Ryosuke
Tanaka, Hirokazu
Shibayama, Hirohiko
Shimazu, Yutaka
Uchiyama, Hitoji
Yoshihara, Satoshi
Adachi, Yoko
Matsuda, Mitsuhiro
Hanamoto, Hitoshi
Uoshima, Nobuhiko
Kosugi, Satoru
Ohta, Kensuke
Yagi, Hideo
Kanakura, Yuzuru
Matsumura, Itaru
Hino, Masayuki
Nomura, Shosaku
Shimazaki, Chihiro
Takaori-Kondo, Akifumi
Kuroda, Junya
Author's alias: 恩田, 佳幸
諫田, 淳也
島津, 裕
髙折, 晃史
Keywords: carfilzomib
dexamethasone
Kd
KRd
lenalidomide
real-world efficacy and safety
relapsed/refractory multiple myeloma
Issue Date: 2022
Publisher: SAGE Publications
Journal title: Therapeutic Advances in Hematology
Volume: 13
Abstract: Background: Little is known about the real-world survival benefits and safety profiles of carfilzomib-lenalidomide-dexamethasone (KRd) and carfilzomib-dexamethasone (Kd). Methods: We performed a retrospective analysis to evaluate their efficacy and safety in 157 patients registered in the Kansai Myeloma Forum database. Results: A total of 107 patients received KRd. Before KRd, 99% of patients had received bortezomib (54% were refractory disease), and 82% had received lenalidomide (57% were refractory disease). The overall response rate (ORR) was 68.2%. The median progression-free survival (PFS) and overall survival (OS) were 8.8 and 29.3 months, respectively. Multivariate analysis showed that reduction of the carfilzomib dose and non-IgG M protein were significantly associated with lower PFS and reduction of the carfilzomib dose and refractoriness to prior bortezomib-based regimens were significantly associated with lower OS. A total of 50 patients received Kd. Before Kd, 96% of patients had received bortezomib (54% were refractory disease). The ORR was 62.0%. The median PFS and OS were 7.1 and 20.9 months, respectively. Based on the multivariate analysis, reduction of the carfilzomib dose and International Staging System Stage III (ISS III) were significantly associated with lower PFS. Grade III or higher adverse events were observed in 48% of KRd cases and 54% of Kd cases. Cardiovascular events, cytopenia, and infections were frequent, and 4 KRd patients died due to heart failure, arrhythmia, cerebral hemorrhage, and pneumonia. Conclusion: Our analysis showed that an adequate dose of carfilzomib is important for achieving the best survival benefits in a real-world setting. Adverse effects after KRd and Kd therapy should also be considered.
Rights: © The Author(s), 2022.
This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
URI: http://hdl.handle.net/2433/276621
DOI(Published Version): 10.1177/20406207221104584
PubMed ID: 35785245
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