Carfilzomib, Lenalidomide, Dexamethasone Prolong Survival in Multiple Myeloma
The phase 3 study ASPIRE previously demonstrated that adding carfilzomib to Rd prolongs progression-free survival, though overall survival data were immature.
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Patients with relapsed/refractory multiple myeloma (RRMM) treated with carfilzomib, lenalidomide, and dexamethasone (KRd) have a clinically significant improvement in overall survival (OS) compared to those treated with lenalidomide and dexamethasone (Rd) alone, according to data presented at the 2017 American Society of Hematology (ASH) Annual Meeting in Atlanta, Georgia.1
The phase 3 study ASPIRE (ClinicalTrials.gov Identifier: NCT01080391) previously demonstrated that adding carfilzomib to Rd prolongs progression-free survival (PFS), though OS data were immature.
The median follow-up was 67 months for the OS analysis. Patients who received KRd had a median OS of 48.3 months (95% CI, 42.4-52.8) compared with 40.4 months (95% CI, 33.6-44.4) among patients treated with Rd (P = .0045).
Patients at first relapse who received KRd had a longer median OS than patients in the Rd arm (47.3 vs 35.9 months; hazard ratio [HR], 0.81; 95% CI, 0.62-1.06), and patients treated with KRd who failed 2 or more lines of therapy had a longer median OS compared with Rd patients (48.8 vs 42.3 months; HR, 0.79; 95% CI, 0.62-0.99).
Ninety-eight percent of patients who received KRd had treatment-emergent adverse events (AEs), which included diarrhea, fatigue, cough, pyrexia, upper respiratory tract infection, hypokalemia, and muscle spasms. Frequently observed AEs included grade 3 or worse acute renal failure, cardiac failure, ischemic heart disease, hypertension, and hematopoietic thrombocytopenia.
In the KRd and Rd groups, 11.5% of patients and 10.5% of patients had fatal AEs, respectively.
The authors concluded that “KRd should be considered a standard of care in RRMM.”
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- Stewart AK, Siegel D, Ludwig H, et al. Overall survival (OS) of patients with relapsed/refractory multiple myeloma (RRMM) treated with carfilzomib, lenalidomide, and dexamethasone (KRd) versus lenalidomide and dexamethasone (Rd): final analysis from the randomized phase 3 ASPIRE trial. Oral presentation at: American Society of Hematology 59th Annual Meeting & Exposition; December 9-12, 2017; Atlanta, GA.