Multiple Myeloma Coverage from Every Angle

Updated Results With Carfilzomib Triplet in Transplant-Eligible Patients With Myeloma

By: Sarah Campen, PharmD
Posted: Monday, January 14, 2019

Based on high response rates in previous studies, researchers have evaluated the effectiveness of several carfilzomib-based triplet combinations in patients with newly diagnosed multiple myeloma who were eligible for a stem cell transplant. Francesca Gay, MD, PhD, of the University of Torino, Italy, and colleagues presented updated results of the phase III FORTE trial at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 121).

The researchers randomly assigned 474 patients younger than age 65 with newly diagnosed multiple myeloma equally to 1 of 3 treatment arms. They included induction with carfilzomib combined with cyclophosphamide and dexamethasone (KCd) followed by autologous stem cell transplantation (ASCT) and consolidation with KCd (KCd-ASCT-KCd, n = 159); induction with carfilzomib combined with lenalidomide and dexamethasone (KRd) followed by transplant and consolidation with KRd (KRd-ASCT-KRd, n = 158); or 12 cycles of KRd (KRd12, n = 157) without transplant.

Patients in the KRd-ASCT-KRd and KRd12 arms had significantly higher rates of response compared with patients in the KCd-ASCT-KDd arm; the rates of stringent complete response were 44%, 43%, and 32%, and the rates of minimal residual disease negativity were 58%, 54%, and 42%, respectively. No differences in minimal residual disease and overall best response were observed between KRd-ASCT-KRd and KRd12.

Therapy was reported to be well tolerated; the most frequent grade 3 or 4 adverse events in all treatment arms were neutropenia, thrombocytopenia, and infections. Grade 3 or 4 dermatologic adverse events, an increase in liver enzymes, and hypertension were more frequent with KRd12. The rate of treatment discontinuation due to adverse events was similar in all study arms.

Dr. Gay and colleagues plan to continue to follow the study participants to evaluate progression-free and overall survival rates.

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

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