Myeloma: Carfilzomib Superior to Bortezomib Regardless of Number of Prior Treatments

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Carfilzomib is superior to bortezomib, regardless of prior exposure to either bortezomib or lenalidomide, for patients with MM.
Carfilzomib is superior to bortezomib, regardless of prior exposure to either bortezomib or lenalidomide, for patients with MM.

For patients with relapsed/refractory multiple myeloma, carfilzomib is superior to bortezomib for progression-free survival, regardless of previous treatments or prior exposure to either bortezomib or lenalidomide, a subgroup analysis of the ENDEAVOR trial published in Leukemia has shown.1

For this multicenter, open-label, pivotal, phase 3 trial, researchers randomly assigned 929 patients with relapsed/refractory multiple myeloma to receive carfilzomib plus low-dose dexamethasone, or bortezomib plus low-dose dexamethasone. Participants received treatment until disease progression. After a median follow-up of 11.9 months in the carfilzomib group and 11.1 months in the bortezomib group, median progression-free survival was 18.7 months and 9.4 months, respectively (hazard ratio, 0.53; 95% CI, 0.44-0.65; P < .0001).

Investigators conducted a subgroup analysis of data from patients, categorized either by the number of previous therapies or by prior treatment. For patients with 1 prior therapy, median progression-free survival was 22.2 months with carfilzomib, versus 10.1 months with bortezomib. For patients who received 2 or more prior lines, median progression-free survival was 14.9 months and 8.4 months, respectively.

Among patients previously treated with bortezomib, median progression-free survival was 15.6 months for carfilzomib, in contrast with 8.1 months with bortezomib; for those previously treated with lenalidomide, median progression-free survival was 12.9 months versus 7.3 months, respectively.

RELATED: Updated Outcomes From Multiple Myeloma Study Support New Standard of Care

Overall response rates were 81.9% versus 65.5% after 1 prior line, 72.0% versus 59.7% after 2 or more prior lines, 71.2% versus 60.3% with prior bortezomib, and 70.1% versus 59.3% with prior lenalidomide for carfilzomib and bortezomib, respectively.

Toxicity profiles associated with carfilzomib-dexamethasone and bortezomib-dexamethasone in each subgroup were similar to those of the overall study population.


1. Moreau P, Joshua D, Chng W-J, et al. Impact of prior treatment on patients with relapsed multiple myeloma treated with carfilzomib and dexamethasone vs bortezomib and dexamethasone in the phase 3 ENDEAVOR study. Leukemia. In press.

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