A phase 3 head-to-head trial comparing the effectiveness of Kyprolis (carfilzomib) in combination with dexamethasone has shown better outcomes in patients with multiple myeloma than the current standard of care, which utilizes the drugs Velcade (bortezomib) plus dexamethasone.
Multiple myeloma is a rare, incurable form of blood cancer. Many new therapies have been developed for myeloma in recent years, but few head-to-head trials have been done to directly compare these treatments within the same patient populations, making it difficult for health care providers to determine which treatment is best for their patients.
In the phase 3 study published in The Lancet Oncology, researchers tested carfilzomib plus dexamethasone versus bortezomib plus dexamethasone in 929 patients with multiple myeloma. Patients receiving the carfilzomib combination showed substantial improvement, with progression-free survival being almost two times as long as that of patients receiving the bortezomib combination (18.7 months vs. 9.4 months). The carfilzomib combination was found to be superior on secondary endpoints as well; patients receiving this treatment achieved a higher overall response rate (76.9% vs. 62.6%) and had a lower rate of grade 2 or higher neuropathy events (6% vs. 32%) than patients receiving the current standard of care.
“In this head-to-head comparison, carfilzomib plus dexamethasone resulted in a twofold decrease in the risk of progression or death, compared with bortezomib plus dexamethasone, a result that was consistent regardless of age or prior bortezomib exposure,” said study co-author and investigator, Meletios A. Dimopoulos, MD, University of Athens, Greece. “For patients with multiple myeloma, these results are clinically meaningful and translate to more than nine months without disease progression.”
Equally promising was the fact that the newer drug combination was well tolerated by patients. The most common adverse events were diarrhea, anemia, fatigue, dyspnea, pyrexia, and insomnia. Discontinuation of treatment as well as on-study deaths were also comparable between the two study arms, indicating that carfilzomib could offer significant improvement in the treatment of multiple myeloma cancer progression with the same or similar risk of adverse side effects.
