Multiple Myeloma Coverage from Every Angle

Carfilzomib-Based Therapy for Resistant Myeloma: Frailty Index and Outcomes

By: Sarah Campen, PharmD
Posted: Tuesday, August 27, 2019

The previously reported results of the ASPIRE and ENDEAVOR studies found that treatment with carfilzomib-based regimens showed a survival benefit, regardless of age, in patients with relapsed or refractory multiple myeloma. Now, a new subgroup analysis of the phase III trials has found that carfilzomib-based therapy significantly improved both progression-free and overall survival regardless of the patient’s frailty status as well. Thierry Facon, MD, of the Hôpital Claude Huriez, Lille, France, and colleagues presented their findings at the 2019 American Society for Clinical Oncology Annual Meeting (Abstract 8028) and published them in the Journal of Clinical Oncology.

In this post hoc analysis, 1,610 patients were categorized by their assigned treatment arm and frailty score—a value based on age, comorbidities, and functional status. A frailty score of 0 was deemed “fit,” a score of 1 was “intermediate,” and a score of at least 2 was considered “frail.” The ASPIRE study compared a regimen of carfilzomib at 27 mg/m2, lenalidomide, and dexamethasone with lenalidomide plus dexamethasone, whereas the ENDEAVOR trial compared carfilzomib at 56 mg/m2 plus dexamethasone with bortezomib plus dexamethasone.

Across all three frailty subgroups in both studies, the median progression-free and overall survival rates in the carfilzomib study arms were consistently improved. Although the rates of treatment-related adverse events leading to treatment discontinuation were higher in the carfilzomib arms, Dr. Facon and colleagues concluded that “these findings support the favorable benefit-risk profile of [carfilzomib-lenalidomide-dexamethasone] and [carfilzomib-dexamethasone] regardless of frailty score.”

Disclosure: The study authors’ disclosure information may be found at

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