Carfilzomib Dosing Intensity Among Real-World Patients With MM

Findings from a recent real-world study suggest that high intensity dosing of carfilzomib as a single agent or in combination with dexamethasone may improve outcomes among patients with multiple myeloma (MM; J Oncol Pharm Pract. 2021 Jun 10; 10781552211015283. doi:10.1177/10781552211015283).

“Carfilzomib dosing as a single agent or in combination with dexamethasone (Kd) has evolved from the initial 27 mg/m2 twice-weekly (legacy dose), to more recently approved doses of 56 mg/m2 twice-weekly and 70 mg/m2 once-weekly (optimized doses),” wrote Noopur Raje, MD, Massachusetts General Hospital, Hematology/Oncology, Boston, MA, and colleagues.

This study aimed to evaluate overall survival (OS) and time to next treatment (TTNT) among patients with MM treated with Kd optimized vs legacy dosing in the real-world setting.

IQVIA’s oncology electronic medical records database was used to identify and analyze patients treated with Kd between January 1, 2013, and July 31, 2017.

The Kd-initiation date until death was used to calculate OS, and the data on body surface area was used to calculate the Kd dose. Time from Kd-initiation until the start of subsequent treatment was used to determine the time to next treatment. OS and time to next treatment were evaluated through Cox models and Kaplan-Meier analysis.

Among the 1469 patients included in this study, 129 (8.8%) received optimized dose, while 1340 (91.2%) received legacy dose. When compared to patients receiving the legacy doses, those who received the optimized doses experienced 64% lower risk of mortality, 33% lower risk of progressing to the subsequent treatment, and significantly longer time to next treatment.

“Patient outcomes could be improved if eligible MM patients are treated with the optimized, recently approved Kd doses (56 mg/m2 twice-weekly and 70 mg/m2 once-weekly),” concluded Dr Raje and colleagues.—Marta Rybczynski