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Treatment with 40 mg dexamethasone and 70 mg/m2 carfilzomib administered once weekly (Kd70) has a favorable safety and efficacy profile in patients with relapsed or refractory multiple myeloma (MM), according to results from the phase 3 ARROW trial (ClinicalTrials.gov Identifier: NCT02412878) presented at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago, Illinois.
In this study, patients with relapsed or refractory MM were randomly assigned to receive either once-weekly Kd70 or 40 mg dexamethasone once weekly and 27 mg/m2 carfilzomib twice weekly (Kd27).
Researchers used a frailty scale including measures of age, comorbidities, and functional status to categorize patients as fit (126 patients), intermediate (189 patients), or frail (139). The outcomes assessed were progression-free survival (PFS) and safety, stratified by treatment arm and frailty status.
In fit patients, median PFS was 15.7 months in the once-weekly Kd70 group and 5.7 months in the twice-weekly Kd27 group. In intermediate patients, median PFS was 11.1 months in the once-weekly Kd70 group and 7.7 months in the twice-weekly Kd27 group. In frail patients, median PFS was 10.3 months in the once-weekly Kd70 group and 6.6 months in the twice-weekly Kd27 group.
Grade 3 or higher treatment-emergent adverse events occurred at similar rates between treatment arms and was independent of frailty. There were no cases of grade 3 or higher peripheral neuropathy or pulmonary hypertension in the once-weekly Kd70 group.
“These results support weekly Kd70 as a treatment option for both fit and frail patients with relapsed or refractory MM,” the authors stated.
1. Mateos M-V, Ludwig H, Kumar S, et al. Safety and efficacy of once-weekly carfilzomib (K) dosing in frail patients (pts): A subgroup analysis from the phase 3 A.R.R.O.W. study. Poster presentation at: 2019 ASCO Annual Meeting; June 3, 2019; Chicago, IL. Abstract 8027.