Carfilzomib-Based Induction Regimen in Newly Diagnosed Multiple Myeloma
Posted: Monday, March 2, 2020
According to the initial results of the phase II CARDAMON trial, presented at the 2019 American Society of Hematology Annual Meeting in Orlando (Abstract 861) and published in the journal Blood, a combination treatment of carfilzomib, cyclophosphamide, and dexamethasone (K56Cd) may prove to be an effective front-line treatment for patients with newly diagnosed multiple myeloma. Although there are data supporting the higher dose of 56 mg/m2 of carfilzomib in a doublet regimen with dexamethasone, few data exists on this dose in triplet regimens in this patient population.
“K56Cd has equivalent [minimal residual disease]-negative rates in adverse- and standard-risk disease,” concluded Roger G. Owen, MD, of St. James’s University Hospital in the United Kingdom, and colleagues.
The study included 252 transplant-eligible patients with newly diagnosed multiple myeloma who underwent 4 cycles of 28-day K56Cd treatment. Participants received 20/56 mg/m2 of carfilzomib intravenously on days 1, 2, 8, 9, 15, and 16; 500 mg of oral cyclophosphamide on days 1, 8, and 15; and 20 mg of dexamethasone on days 1, 2, 8, 9, 15, and 16. Patients experiencing a response who had previously undergone a successful stem cell harvest were randomly assigned to receive either autologous stem cell transplantation or four additional K56Cd treatment cycles, either of which were followed by maintenance carfilzomib for 18 months.
At the end of induction therapy or stem cell harvest, 59.2% of patients experienced at least a very good partial response, and the overall response rate was 87.6%. For those with adverse-risk disease, 53.4% achieved at least a very good partial response versus 61.9% for those with standard-risk disease. A total of 24.1% of participants were minimal residual disease–negative after stem cell harvest. Overall, 114 serious adverse events were reported in 72 patients, including renal impairment, grade 3 cardiac ischemia, and grade 3 hypertension.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.