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Carfilzomib‐containing combinations as frontline therapy for multiple myeloma: A meta‐analysis of 13 trials
Author(s) -
Sheng Zhixin,
Li Guifang,
Li Bin,
Liu Yanju,
Wang Lida
Publication year - 2017
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12877
Subject(s) - carfilzomib , regimen , medicine , multiple myeloma , oncology , urology , bortezomib
Objective To investigate the activity and safety of carfilzomib‐containing combinations as frontline therapy for multiple myeloma. Methods We searched published carfilzomib reports for newly diagnosed multiple myeloma. Results Thirteen trials were identified, covering 704 subjects. Pooled analysis showed that carfilzomib combinations as frontline therapy for multiple myeloma attained an impressive at least complete response (≥ CR ) rate of 21%, at least very good partial response (≥ VGPR ) rate of 68%, overall response rate ( ORR ) of 94%. The ≥ CR rates of 18% pre‐ SCT were increased to 43% of post‐ ASCT , and 64% of postconsolidation ( P <.001). For those patients receiving carfilzomib therapy, response quality improved further over time (≥ CR rates of 10% after 2nd cycle, 20% after 4th cycle, 43% after 8th cycle; ≥ VGPR of 29% after 2nd cycle, 68% after 4th cycle, 88% after 8th cycle). ≥ CR rates of 49% from CFZ ‐ LEN ‐ DEX triplet regimen were higher than 18% from CFZ ‐ CYC ‐ DEX triplet regimen and 21% from CFZ ‐ THA ‐ DEX triplet regimen ( P =.03). Conclusions Carfilzomib combinations could produce clinical benefits in newly diagnosed patients with multiple myeloma. High‐quality response rate could be further improved through ASCT , consolidation therapy, and more cycles of chemotherapy even in the era of carfilzomib. CFZ ‐ LEN ‐ DEX could be a good combination regimen.