ASCO20: Carfilzomib Versus Bortezomib in Newly Diagnosed Myeloma
Posted: Monday, June 1, 2020
The combination of lenalidomide, dexamethasone, and the next-generation proteasome inhibitor carfilzomib (KRd) did not improve survival outcomes compared with lenalidomide, dexamethasone, and bortezomib (VRd), in the randomized phase III ENDURANCE trial of more than 1,000 patients with newly diagnosed multiple myeloma. According to results presented by Shaji Kumar, MD, of the Mayo Clinic in Rochester, Minnesota, and coauthors during the ASCO20 Virtual Scientific Program (Abstract LBA3), “no differences were seen based on age, the presence or absence of t(4;14), or International Staging System stage.”
For patients with standard- and intermediate-risk newly diagnosed multiple myeloma, VRd should remain the standard triplet induction regimen, the team stated. Once data are mature, ENDURANCE will also examine whether indefinite maintenance with lenalidomide improves overall survival compared with 2-year maintenance therapy.
The patients’ median age was 65 years, and none had del17p, t (14;16), t(14;20), plasma cell leukemia, or a high-risk GEP70 profile. Median progression-free survival was 34.4 months with VRd (n = 542) and 34.6 months with KRd (n = 545; P = .74), and 3-year overall survival rates were 84% and 86% with VRd and KRd, respectively. “A significantly higher rate of cardiopulmonary and renal toxicity was observed with KRd, whereas neuropathy rates were higher with VRd,” Dr. Kumar and colleagues pointed out.
Disclosure: The study authors’ disclosure information can be found at coi.asco.org.