Open AccessPS1406 WEEKLY CARFILZOMIB, LENALIDOMIDE AND DEXAMETHASONE UNTIL PROGRESSION IN RELAPSED REFRACTORY MULTIPLE MYELOMA
Author(s) -
Gruchet C.,
Richez V.,
Guidez S.,
Tomowiak C.,
Fouquet G.,
Machet A.,
Moya N.,
Sabirou F.,
Levy A.,
Bobin A.,
Gardeney H.,
Bouyer S.,
Bridoux F.,
Javaugue V.,
Azais I.,
Durand G.,
Loiseau H. Avet,
Leleu X.
Publication year - 2019
Publication title -
hemasphere
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 11
ISSN - 2572-9241
DOI - 10.1097/01.hs9.0000563900.96659.44
Subject(s) - carfilzomib , lenalidomide , medicine , dexamethasone , multiple myeloma , refractory (planetary science) , oncology , physics , astrobiology
Background: Carfilzomib, Lenalidomide and Dexamethasone association (KRd) has led to approval in early RRMM. On ASPIRE International phase 3 study Carfilzomib was used on a twice a week basis at 27 mg/m 2 and limited to 18 months exposure. We have reported already that KRd on a weekly basis at 56 mg/m 2 had similar and safe properties. In this abstract we report the long‐term exposure data on KRd weekly given at 56 mg/m 2 until progression. Aims: We aimed to evaluate the efficacy of KRd given on a prolong duration beyond 18months, and to validate the safety profile of continuous exposure to Carfilzomib. Methods: 28 patients were prospectively recruited. Carfilzomib 20/56 mg/m 2 was administered on days 1,8,15 on 28 days cycles. Lenalidomide (25 mg/day) was given 21/28 days and Dexamethasone was administered weekly. Patients were treated until progression. Results: With a median follow‐up at start of KRd of 30 months, 50% of patients relapsed and 39% died. 24/28 patients received 1 prior line of treatment. 8/28 patients are still on treatment with duration > 24 month and 6/28 with duration > 30 months. The median number of cycles was 15. ORR and CBR was 85.7% and 89.3%, whom 46% ≥ CR; with a median DOR of 13 months and 43% having more than 18 months. 6 patients had negative MRD at 10 –6 and normalized PET CT. Median of OS is not reached, and the 30 month‐expected OS from the start of KRd was 56%. The median PFS and EFS was at 29 months, and the 30 month‐expected PFS and EFS was 45%. PFS and EFS being superimposable speaks to that there was no safety concern related to prolonged exposure to K. Only 4 patients stopped KRd for safety issues. Hematologic and non‐hematologic adverse events ≥ grade 3 were reported in 16/28 and 10/28 patients. Adverse events ≥ grade 3 seen in ≥10% of patients were neutropenia, thrombocytopenia, vomiting and pyrexia. Of note, 5 patients (18%) were 3 65 years old and these patients showed similar data compared to the studied cohort. Summary/Conclusion: KRd weekly at 20/56 mg/m 2 is effective and safe to early RRMM patients, provides improved safety profile to patients allowing treating patients until progression. Further studies are warranted to confirm this data on a larger early RRMM population and validate the concept of long duration of treatment using Carfilzomib combination.