Prognostic impact of resistance to bortezomib and/or lenalidomide in carfilzomib‐based therapies for relapsed/refractory multiple myeloma: The Kyoto Clinical Hematology Study Group, multicenter, pilot, prospective, observational study in Asian patients

Cancer Reports

Kyoto Clinical Hematology Study Group (KOTOSG) Investigators¹  Kazuho Shimura²  Hiroto Kaneko²  Masafumi Taniwaki²  Yoshiaki Chinen³  Koichi Hirakawa³  Hitoji Uchiyama⁴  Nana Sasaki⁵  Nobuhiko Uoshima⁵  Miki Kiyota⁶  Katsuya Wada⁶  Ryoichi Takahashi⁷  Chihiro Shimazaki⁸  Shin‐ichi Fuchida⁸  Mitsushige Nakao⁹  Tsutomu Kobayashi^1,10  Shinsuke Mizutani^1,10  Yuji Shimura^1,10  Yuka Kawaji‐Kanayama^1,10  Taku Tsukamoto^1,10  Shigeo Horiike^1,10  Yayoi Matsumura‐Kimoto^1,10  Ayako Muramatsu^1,10  Junya Kuroda^1,10 

[1] ;Department of Hematology Aiseikai Yamashina Hospital Kyoto Japan;Department of Hematology Fukuchiyama City Hospital Fukuchiyama Japan;Department of Hematology Japanese Red Cross Kyoto Daiichi Hospital Kyoto Japan;Department of Hematology Japanese Red Cross Kyoto Daini Hospital Kyoto Japan;Department of Hematology Matsushita Memorial Hospital Moriguchi Japan;Department of Hematology Omihachiman Community Medical Center Omihachiman Japan;Department of Hematology, Japan Community Health care Organization Kyoto Kuramaguchi Medical Center Kyoto Japan;Department of Internal Medicine Otsu Municipal Hospital Otsu Japan;Division of Hematology and Oncology, Department of Medicine Kyoto Prefectural University of Medicine Kyoto Japan;

关键词: bortezomib;    carfilzomib;    lenalidomide;    multiple myeloma;   

DOI  :  10.1002/cnr2.1476

来源: DOAJ

【 摘 要 】

Abstract Background Combinatory strategies with carfilzomib (CFZ), a second‐generation proteasome inhibitor, plus dexamethasone (DEX) with or without lenalidomide (LEN) have shown promising efficacy for patients with relapsed/refractory multiple myeloma (RRMM) in pivotal clinical trials. However, their effects on patients who were resistance to bortezomib (BTZ) and/or LEN have not been fully evaluated in a daily practice setting. Aims To evaluate the real‐world efficacy and safety of CFZ‐based treatments; that is, CFZ with LEN plus DEX (KRD therapy) and CFZ with DEX (KD therapy), in Asian patients, we conducted a multicenter pilot prospective observational study in the Kyoto Clinical Hematology Study Group. Methods and Results All 50 patients with RRMM enrolled in this study were treated with CFZ‐based treatments between 2017 and 2019. KRD and KD were administered to 31 and 19 patients, respectively. The overall response rates (ORRs) were 80.6% with KRD and 73.7% with KD. Two‐year progression‐free survival (PFS) and overall survival (OS) were 58.5% and 79.7% with KRD, and 23.1% and 52.6% with KD. By multivariate analysis, refractoriness to BTZ and to LEN were identified as independent unfavorable factors for both PFS and OS. The common non‐hematologic AEs included hypertension (42.0%), fever (24.0%), fatigue (24.0%), and infection (16.0%). No serious heart failure was observed. This study is registered as UMIN000025108. Conclusion This study suggests the need of the development of novel CFZ‐containing strategy which can overcome the refractoriness to BTZ and/or LEN, while both KRD and KD were shown to be mostly feasible in Asian patients in a daily practice setting.

【 授权许可】

Unknown