Title
Carfilzomib, thalidomide, and dexamethasone is safe and effective in relapsed and/or refractory multiple myeloma: final report of the single arm, multicenter phase II ALLG MM018/AMN002 study.
Link to article in PubMed
Author(s)
Ninkovic, Slavisa
Harrison, Simon J
Lee, Je-Jung
Murphy, Nick
Lee, Jae Hoon
Estell, Jane
Chen, Vivien M
Horvath, Noemi
Kim, Kihuyn
Eek, Richard
Augustson, Bradley
Bang, Soo-Mee
Huang, Shang-Yi
Rajagopal, Rajeev
Engeler, Daniel
Butcher, Belinda E
Mollee, Peter
Durie, Brian
Chng, Wee Joo
Quach, Hang
Abstract
This multicentre, phase II study of the Australian Lymphoma and Leukaemia Group (ALLG) and the Asian Myeloma Network (AMN) investigated fixed-duration (18-month) treatment with carfilzomib (K), thalidomide (T), and dexamethasone (d; KTd) in patients with relapsed and/or refractory multiple myeloma and 1-3 prior lines of therapy. Patients received induction with up to twelve 28-day cycles of K [20mg/m2 IV cycle 1 day 1 and 2, 56mg/m2 (36mg/m2 for patients ≥75 years) from day 8 onwards), T 100mg PO nocte and weekly dexamethasone 40mg (20mg for patients ≥75 years). During maintenance T was omitted, while K continued on days 1,2,15,16 with fortnightly dexamethasone. The primary endpoint was progression free survival (PFS). Secondary endpoints were overall response rate, overall survival (OS), duration of response, safety, and tolerability. Ninety-three patients (median age 66.3 years (41.9 - 84.5)) were enrolled with a median follow-up of 26.4 (1.6 - 54.6) months. The median PFS was 22.3 months (95% CI 15.7 - 25.6) with a 46.3% (95% CI 35.1 - 52.8) 2-year PFS. Median OS was not reached and was 73.8% (95% CI 62.9 - 81.9) at 2 years. The overall response rate was 88% (≥ VGPR 73%). There was no difference in the depth of response, PFS or OS comparing Asian and Non-Asian cohorts (p=0.61). The safety profile for KTd was consistent with each individual drug. KTd is well tolerated and effective in patients with RRMM irrespective of Asian or non-Asian ethnicity and provides an alternative option particularly where use of KRd is limited by access, cost, or renal impairment.
Publication information
Haematologica. 2024 Jan 18. doi: 10.3324/haematol.2023.284238.
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MM18_Publication_Haematologica Early View_18Jan2024.pdf
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3.77 MB
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Checksum
(MD5):0d1bc00407d23a1d6ba84de5c017ba06
Date Issued
2024-07-01
Type
Journal Article
Journal Title
Haematologica
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