Volumen: 20 # Number : 3
Publication Date : Septiembre - Diciembre Year: 2016
Argentine multicentric experience of carfilzomib use in
relapsed / refractory multiple myeloma.
Authors: Duarte P, Schutz N, Ochoa P, Quiroga L, Corzo A,
Riva M E, Salinas G, Verri V, Enrico , Orlando S,
Dufour C, Cruset S, Pintos N, Bonder M,
Shanley C, Remaggi G, Real J,Mariano R, Ferro H,
Negri Aranguren P, Vaca M V, Cerana S, Fantl D.
Abstract: Carfilzomib is a selective proteosome inhibitor recently
approved for the treatment of relapsed and
refractory multiple myeloma (RRMM) in patients
treated with bortezomib and immunomodulatory
drugs. We evaluated the efficacy and toxicity of carfilzomib
based treatments in this group of patients.
Data on 60 patients treated with at least 2 previous
treatment lines were analyzed. Patients received
carfilzomib intravenous 20 mg/m2 on cycle 1 and 27
mg/m2 in following cycles, on days 1, 2, 8, 9, 15 and
22 of 28 days cycles, alone or combined with other
agents. All patients have been previously treated
with bortezomib and immunomodulatory drugs, and
33 patients (55%) were refractory to at least one of
these drugs. Overall response (≥ partial response)
was 54% (32/60 of evaluable patients), complete response
was found in 2 patients (3%) and very good
partial response in 2 patients. Bortezomib refractory
patients had inferior responses compared to the
not refractory ones, with an overall response of 26%
(p: 0.016). Median progression free survival was 10
months (IC95 5-15). Median overall survival was
14 months (IC95 8-20) for the complete cohort, 11
months (IC95 6-15) for not responders and not yet
reached for responders (p: 0.0001). Seven patients
(12%) discontinued treatment due to adverse events
(AEs) related to carfilzomib. The more common
AEs (any grade) were: anemia (40%), neutropenia
(32%), trombocytopenia (22%), dyspnea (12%),
gastrointestinal (11%) and arterial hypertension
(10%). In conclusion carfilzomib alone or in combination
with other agents has shown efficacy for
the treatment of RRMM patients with an acceptable
toxicity.
Key words: carfilzomib,
relapsed/refractory multiple myeloma,
bortezomib,
immunomodulatory drugs
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