Renal Response and Outcomes in Myeloma: Carfilzomib- or Bortezomib-Based Therapy
Posted: Tuesday, March 16, 2021
Moderate to severe renal impairment is common among patients with multiple myeloma and is associated with a poor prognosis and early death. However, according to the real-world phase III ENDEAVOR trial, carfilzomib plus dexamethasone may improve survival more than bortezomib plus dexamethasone in patients with relapsed or refractory multiple myeloma, regardless of baseline renal function. The study also found that patients who responded to either carfilzomib or bortezomib treatment appeared to achieve significantly longer overall survival and time to next treatment than those who did not respond. The report was published in Blood Advances.
“Our findings suggest a consistent clinical benefit of carfilzomib over bortezomib in patients with multiple myeloma with various degrees of renal impairment,” Noopur Raje, MD, of Massachusetts General Hospital, Boston, and colleagues concluded.
Using electronic medical records data from the Oncology Services Comprehensive Electronic Records database, the researchers assessed renal response and renal impairment among patients with multiple myeloma between January 2012 and February 2018. Patients were treated with carfilzomib plus dexamethasone (n = 543) or bortezomib plus dexamethasone (n = 1,005).
Among patients in their second line of therapy, significantly higher renal overall response rates were observed in the carfilzomib arm compared with the bortezomib arm (51.4% vs. 39.6%; P < .0001). Renal complete response rates were also significantly higher among patients treated with carfilzomib versus bortezomib (26.6% vs. 22.2%; P = .02). After adjusting for baseline covariates, patients who received carfilzomib were 45% more likely to achieve renal overall response and 68% more likely to achieve renal complete response compared with patients who received bortezomib. Regardless of the line of therapy, patients receiving carfilzomib achieved consistent renal response benefits.
Disclosure: For full disclosures of the study authors, visit ashpublications.org.
