The combination of carfilzomib, lenalidomide, and dexamethasone (KRd) may be more effective for the treatment of multiple myeloma than the combination of lenalidomide and dexamethasone (Rd) only, regardless of cytogenetic abnormalities, according to a study published in Blood.1

To determine the efficacy of KRd with contrast to Rd, particularly for patients who displayed cytogenetic abnormalities classified as “standard-risk” or “high-risk”, researchers enrolled 792 patients to this phase 3 ASPIRE study.

Of the 417 patients with known cytogenetic abnormalities, 100 were categorized as having high-risk cytogenetics, and 317 were categorized as having standard-risk cytogenetics.

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Progression-free survival was improved by 9 months for “high-risk” patients in the KRd cohort, and by 10 months for “standard-risk” patients.

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Almost 5 times as many patients with any cytogenetic abnormalities achieved a complete response or better with KRd than with Rd.

The authors concluded that KRd was more efficacious in this treatment environment than Rd, and ought to be adopted as a standard of care.


  1. Avet-Loiseau H, Fonseca R, Siegel D, et al. Carfilzomib significantly improves the progression free survival of high-risk patients in multiple myeloma. 20 Jul 2016. Blood. doi: 10.1182/blood-2016-03-707596 [Epub ahead of print]