TY - JOUR
TI - Carfilzomib-lenalidomide-dexamethasone vs lenalidomide- dexamethasone in relapsed multiple myeloma by previous treatment
AU - Dimopoulos, M.A.
AU - Stewart, A.K.
AU - Masszi, T.
AU - Spicka, I.
AU - Oriol, A.
AU - Hájek, R.
AU - Rosiñol, L.
AU - Siegel, D.
AU - Mihaylov, G.G.
AU - Goranova-Marinova, V.
AU - Rajnics, P.
AU - Suvorov, A.
AU - Niesvizky, R.
AU - Jakubowiak, A.
AU - San-Miguel, J.
AU - Ludwig, H.
AU - Ro, S.
AU - Aggarwal, S.
AU - Moreau, P.
AU - Palumbo, A.
JO - Blood cancer journal
PY - 2017
VL - 7
TODO - 4
SP - null
PB - Nature Publishing Group
SN - null
TODO - 10.1038/bcj.2017.31
TODO - carfilzomib;  dexamethasone;  lenalidomide;  antineoplastic agent;  carfilzomib;  dexamethasone;  lenalidomide;  oligopeptide;  thalidomide, acute kidney failure;  adult;  adverse drug reaction;  aged;  anemia;  arthralgia;  Article;  asthenia;  backache;  bronchitis;  cataract;  comparative study;  constipation;  controlled study;  coughing;  decreased appetite;  diarrhea;  disease course;  disease severity;  dizziness;  drug efficacy;  dyspnea;  edema;  faintness;  fatigue;  fever;  heart failure;  human;  hyperglycemia;  hypertension;  hypocalcemia;  hypokalemia;  hypophosphatemia;  insomnia;  ischemic heart disease;  leukopenia;  lung embolism;  lymphocytopenia;  multiple myeloma;  muscle spasm;  nausea;  neutropenia;  open study;  overall survival;  pain;  phase 3 clinical trial;  pneumonia;  progression free survival;  quality of life;  randomized controlled trial;  rash;  refractory multiple myeloma;  relapse;  relapsed multiple myeloma;  respiratory tract infection;  rhinopharyngitis;  thrombocytopenia;  treatment duration;  treatment response;  upper respiratory tract infection;  very elderly;  vomiting;  analogs and derivatives;  clinical trial;  disease free survival;  female;  male;  middle aged;  multiple myeloma;  pathology;  treatment outcome;  tumor recurrence, Adult;  Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Dexamethasone;  Disease-Free Survival;  Female;  Humans;  Male;  Middle Aged;  Multiple Myeloma;  Neoplasm Recurrence, Local;  Oligopeptides;  Thalidomide;  Treatment Outcome
TODO - Carfilzomib, a proteasome inhibitor, is approved as monotherapy and in combination with dexamethasone or lenalidomide- dexamethasone (Rd) for relapsed or refractory multiple myeloma. The approval of carfilzomib-lenalidomide-dexamethasone (KRd) was based on results from the randomized, phase 3 study ASPIRE (NCT01080391), which showed KRd significantly improved progression-free survival (PFS) vs Rd (median 26.3 vs 17.6 months; hazard ratio (HR) = 0.690; P = 0.0001). This subgroup analysis of ASPIRE evaluated KRd vs Rd by number of previous lines of therapy and previous exposure to bortezomib, thalidomide or lenalidomide. Treatment with KRd led to a 12-month improvement in median PFS vs Rd after first relapse (HR 0.713) and a 9-month improvement after 2 previous lines of therapy (HR 0.720). Treatment with KRd led to an approximate 8-month improvement vs Rd in median PFS in bortezomib-exposed patients (HR 0.699), a 15-month improvement in thalidomide-exposed patients (HR 0.587) and a 5-month improvement in lenalidomideexposed patients (HR 0.796). Objective response and complete response or better rates were higher with KRd vs Rd, irrespective of previous treatment. KRd had a favorable benefit-risk profile and should be considered an appropriate treatment option for patients with 1 or 2 previous lines of therapy and those previously exposed to bortezomib, thalidomide or lenalidomide. © The Author(s) 2017.
ER -