Carfilzomib plus Pomalidomide and Dex Highly Active in Multiple Myeloma

The combination of carfilzomib, pomalidomide, and dexamethasone is well-tolerated and highly active in patients with relapsed and/or refractory multiple myeloma, a new study published online ahead of print in the journal Blood has shown.¹

Because treatment options for patients with heavily pretreated relapsed and/or refractory multiple myeloma remain limited, researchers sought to evaluate a novel therapeutic regimen consisting of carfilzomib, pomalidomide, and dexamethasone.

For the open-label, multicenter study, researchers enrolled 32 patients with multiple myeloma that relapsed after prior therapy or were refractory to the most recently received therapy. All participants were refractory to prior lenalidomide therapy.

Patients received carfilzomib starting at a dose of 20 or 27 mg/mg² intravenously on days 1, 2, 8, 9, 15, and 16, pomalidomide starting at 4 mg orally once daily on days 1 to 21, and dexamethasone 40 mg orally or intravenously on days 1, 8, 15, and 22 of each 28-day cycle.

Results showed that hematological adverse events occurred in ≥60% of all patients, including 11 patients who experienced grade ≥3 anemia. Grade 1/2 dyspnea was reported in 10 patients and grade 1/2 peripheral neuropathy was uncommon.

This is the first clinical trial to investigate carfilzomib, pomalidomide, and dexamethasone in patients with multiple myeloma. Therapy for previously treated multiple myeloma recommended by the NCCN guidelines currently include carfilzomib plus lenalidomide and dexamethasone, and pomalidomide plus dexamethasone.

Reference

1. Shah JJ, Stadtmauer EA, Abonour R, et al. Carfilzomib, pomalidomide, and dexamethasone (CPD) in patients with relapsed and/or refractory multiple myeloma [published online ahead of print on September 17, 2015]. Blood. doi: 10.1182/blood-2015-05-643320.