Two recent phase 3 clinical trials evaluated treatment of patients with relapsed or refractory multiple myeloma with carfilzomib plus dexamethasone (Kd). In a subgroup analysis of both trials, 2 dosing regimens of Kd showed favorable outcomes in Asian patients, according to results reported in the International Journal of Hematology.
From the ENDEAVOR trial, outcomes with Kd (56 patients in this analysis) were compared with outcomes of treatment with bortezomib plus dexamethasone (Vd; 57 patients in this analysis). From the ARROW trial, 2 different Kd dosing strategies were compared: 70 mg/m2 Kd given once per week (30 patients) or 27 mg/m2 Kd given twice per week (15 patients).
In this subgroup analysis, Kd showed an improved median progression-free survival (PFS) compared with Vd (14.9 vs 8.8 months; hazard ratio [HR], 0.599). Once-weekly dosing of Kd yielded a better median PFS compared with twice-weekly dosing (16.0 vs 8.4 months; HR, 0.628).
Medial overall survival (OS) was higher with Kd, at 47.6 months, compared with 38.8 months for Vd (HR, 0.856) in this subgroup analysis. The overall response rate was also higher for Kd compared with Vd (80.4% vs 70.2%) and for once-weekly Kd compared with twice-weekly Kd (76.7% vs 53.3%).
Grade 3 or higher adverse events occurred in 89.1% of included patients who received Kd and 89.5% of those who received Vd in the ENDEAVOR trial. Across the ARROW trial, grade 3 or higher adverse events affected 76.6% of patients who received once-weekly KD and 73.3% of patients receiving twice-weekly Kd.
The researchers concluded that therapy including carfilzomib demonstrated favorable efficacy and an acceptable safety profile across different dosing regimens in Asian patients with relapsed or refractory multiple myeloma.
- Dimopoulos MA, Moreau P, Iida S, et al. Outcomes for Asian patients with multiple myeloma receiving once- or twice-weekly carfilzomib-based therapy: a subgroup analysis of the randomized phase 3 ENDEAVOR and A.R.R.O.W. Trials. Int J Hematol. 2019;110:466-473.