Carfilzomib plus lenalidomide and dexamethasone (KRd) in addition to autologous hematopoietic cell transplantation (auto-HCT) demonstrated superior outcomes compared with KRd without auto-HCT in patients with newly diagnosed multiple myeloma, a study presented at the BMT Tandem Meetings 2016 has shown.1
Because KRd alone has previously been shown to be highly active in patients with newly diagnosed multiple myeloma, researchers sought to evaluate outcomes with KRd plus auto-HCT.
For the phase 2 trial, researchers enrolled 75 transplant-eligible patients with newly diagnosed myeloma. All patients received induction with carfilzomib, lenalidomide, and dexamethasone for 4 cycles, followed by melphalan and auto-HCT. Patients then received KRd consolidation for 4 additional cycles and maintenance KRd for 10 cycles. Single-agent lenalidomide was then continued after KRd maintenance until disease progression.
Results showed that among the 68 evaluable patients, the stringent complete response rate was 68% for KRd plus auto-HCT at the completion of cycle 8 compared with 33% without auto-HCT from the updated study results of KRd alone. At the end of cycle 18, stringent complete response rates were 82% and 55%, respectively.
Researchers found that at a median follow-up of 12.8 months with auto-HCT and 47.5 months without, 2-year progression-free survival was 98% vs 92%, respectively.
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In terms of safety, adverse events were consistent with those previously reported.
It should be noted that this study is limited by its cross-study comparison, but the findings warrant further assessment in a randomized trial.
- Zimmerman T, Griffith K, Jasielec J, et al. Carfilzomib (CFZ, Kyprolis®), lenalidomide (LEN, Revlimid®), and dexamethasone (DEX) (KRd) combined with autologous stem cell transplant (ASCT) shows improved efficacy compared with Krd without ASCT in newly diagnosed multiple myeloma (NDMM). Oral abstract presented at: BMT Tandem Meetings 2016; February 18-22, 2016; Honolulu, HI.