ASH 2017: Adding Carfilzomib to Lenalidomide and Dexamethasone in Relapsed or Refractory Myeloma
The overall survival of patients with relapsed or refractory multiple myeloma improved when treated with the proteasome inhibitor carfilzomib in addition to lenalidomide and dexamethasone (KRd), results of the randomized phase III Aspire trial indicated. The international investigative team was led by A. Keith Stewart, MBChB, MBA, of the Center for Individualized Medicine, Mayo Clinic, Scottsdale, Arizona, who presented the results of the final analysis of this study at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 743).
“KRd demonstrated a statistically significant and clinically meaningful 21% reduction in the risk of death versus Rd [lenalidomide and dexamethasone]. KRd should be considered a standard of care in relapsed or refractory multiple myeloma,” stated Dr. Stewart and colleagues.
Nearly 800 eligible adults with relapsed or refractory multiple myeloma had received between one and three prior lines of therapy and then were randomized to receive KRd or Rd. Median follow-up was 67 months for both arms, with a median overall survival of 48.3 months for KRd versus 40.4 months for Rd (1-sided P = .0045).
For patients who had received one and at least two prior lines of therapy, respectively, median overall survival was 47.3 (KRd) and 35.9 months (Rd), and 48.8 (KRd) and 42.3 months (Rd).
When patients were analyzed by stage, as assessed by the Revised International Staging System, overall survival improved as well with KRd. For patients with stage I, II, and III disease, respectively, median overall survival was not reached (KRd) versus 58.0 months (Rd); 45.4 (KRd) and 41.2 months (Rd); and 23.3 (KRd) and 18.8 months (Rd).