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Once-Weekly vs. Twice-Weekly Carfilzomib in Relapsed or Refractory Myeloma

By: Joseph Cupolo
Posted: Friday, November 3, 2017

In the phase III ARROW study, once-weekly dosing of carfilzomib with dexamethasone in patients with relapsed or refractory multiple myeloma prolonged progression-free survival by 3.6 months compared with twice-weekly dosing with dexamethasone. The trial was conducted in approximately 100 sites worldwide. These findings were reported in Oncology Nurse Advisor.

Researchers randomly assigned 478 patients with relapsed or refractory multiple myeloma to receive carfilzomib at 70 mg/m2 once weekly plus dexamethasone or carfilzomib at 27 mg/m2 twice weekly plus dexamethasone. Patients receiving carfilzomib once weekly had a progression-free survival of 11.2 months vs. 7.6 months for patients receiving the drug twice weekly (hazard ratio = 0.69).

Inclusion criteria for patients accepted into the study included at least two but no more than three prior therapies for multiple myeloma, prior exposure to an immunomodulatory agent, and prior exposure to a proteasome inhibitor. According to the reported results, the overall safety profile of the once-weekly regimen of carfilzomib was comparable to that of its twice-weekly dosing. Anemia, diarrhea, fatigue, insomnia, hypertension, and pyrexia being the most frequently reported adverse events in either treatment arm.