Open AccessPrognostic impact of resistance to bortezomib and/or lenalidomide in carfilzomib‐based therapies for relapsed/refractory multiple myeloma: The Kyoto Clinical Hematology Study Group, multicenter, pilot, prospective, observational study in Asian patients
Author(s) -
KawajiKanayama Yuka,
Kobayashi Tsutomu,
Muramatsu Ayako,
Uchiyama Hitoji,
Sasaki Nana,
Uoshima Nobuhiko,
Nakao Mitsushige,
Takahashi Ryoichi,
Shimura Kazuho,
Kaneko Hiroto,
Kiyota Miki,
Wada Katsuya,
Chinen Yoshiaki,
Hirakawa Koichi,
Fuchida Shinichi,
Shimazaki Chihiro,
MatsumuraKimoto Yayoi,
Mizutani Shinsuke,
Tsukamoto Taku,
Shimura Yuji,
Horiike Shigeo,
Taniwaki Masafumi,
Kuroda Junya
Publication year - 2022
Publication title -
cancer reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 5
ISSN - 2573-8348
DOI - 10.1002/cnr2.1476
Subject(s) - carfilzomib , medicine , bortezomib , lenalidomide , multiple myeloma , oncology , hematology , refractory (planetary science) , proteasome inhibitor , biology , astrobiology
Abstract Background Combinatory strategies with carfilzomib (CFZ), a second‐generation proteasome inhibitor, plus dexamethasone (DEX) with or without lenalidomide (LEN) have shown promising efficacy for patients with relapsed/refractory multiple myeloma (RRMM) in pivotal clinical trials. However, their effects on patients who were resistance to bortezomib (BTZ) and/or LEN have not been fully evaluated in a daily practice setting. Aims To evaluate the real‐world efficacy and safety of CFZ‐based treatments; that is, CFZ with LEN plus DEX (KRD therapy) and CFZ with DEX (KD therapy), in Asian patients, we conducted a multicenter pilot prospective observational study in the Kyoto Clinical Hematology Study Group. Methods and Results All 50 patients with RRMM enrolled in this study were treated with CFZ‐based treatments between 2017 and 2019. KRD and KD were administered to 31 and 19 patients, respectively. The overall response rates (ORRs) were 80.6% with KRD and 73.7% with KD. Two‐year progression‐free survival (PFS) and overall survival (OS) were 58.5% and 79.7% with KRD, and 23.1% and 52.6% with KD. By multivariate analysis, refractoriness to BTZ and to LEN were identified as independent unfavorable factors for both PFS and OS. The common non‐hematologic AEs included hypertension (42.0%), fever (24.0%), fatigue (24.0%), and infection (16.0%). No serious heart failure was observed. This study is registered as UMIN000025108. Conclusion This study suggests the need of the development of novel CFZ‐containing strategy which can overcome the refractoriness to BTZ and/or LEN, while both KRD and KD were shown to be mostly feasible in Asian patients in a daily practice setting.