Carfilzomib Versus Bortezomib in Relapsed or Refractory Multiple Myeloma
Based on the interim overall survival analysis of the phase III ENDEAVOR trial, the proteasome inhibitor carfilzomib provided a “clinically meaningful” reduction in the risk of death compared with bortezomib. Meletios A. Dimopoulous, MD, of the National and Kapodistrian University of Athens, and colleagues reported in The Lancet Oncology: “To our knowledge, carfilzomib is the first and only multiple myeloma treatment that extends overall survival in the relapsed setting over the current standard of care.”
Of the 1096 patients assessed for eligibility, 929 received treatment: half with carfilzomib, and half with bortezomib. The median overall survival was 47.6 months for the carfilzomib group and 40.0 months for the bortezomib group. Treatment-related deaths occurred in 1% of patients in the carfilzomib group and < 1% of patients in the bortezomib group.
Grade 3 or worse adverse events were reported in 81% of those treated with carfilzomib and 71% of those treated with bortezomib. Serious adverse events were experienced by 59% of patients in the carfilzomib group and 40% of patients in the bortezomib group. Anemia, hypertension, pneumonia, thrombocytopenia, fatigue, dyspnea, increased lymphocyte count, diarrhea, and peripheral neuropathy were the most frequent grade 3 or worse adverse events.