title: Carfilzomib and pomalidomide in patients with relapsed and/or refractory multiple myeloma with baseline risk factors.
abstract: While survival times have increased over the last decade, most patients with multiple myeloma (MM) eventually relapse and become refractory to therapy. The treatment of patients with relapsed and/or refractory MM is frequently further complicated by the presence of pre-existing comorbidities that arise from an advanced disease state and of toxicities stemming from prior antimyeloma treatment. Carfilzomib and pomalidomide have recently been approved for the treatment of patients with relapsed and refractory MM. While these agents represent important additions to the available treatment options, the identification of patients who may best benefit from the use of each of therapy is still being investigated. A number of patient-related and disease-related factors may impact treatment efficacy and/or tolerability, and the clinical presentation and medical history of each patient must be carefully considered to optimize treatment. Here, we review results from carfilzomib and pomalidomide clinical trials in patients with relapsed and/or refractory MM who also have baseline comorbidities or treatment-induced or disease-induced complications (including the presence of renal impairment, cardiac risk factors, peripheral neuropathy, or high-risk chromosomal abnormalities) to evaluate the safety and efficacy of the two agents in these difficult-to-treat patients and to provide treatment recommendations specific to each scenario.
authors.affiliation: Department of Clinical Therapeutics, National and Kapodistrian University of Athens School of Medicine, Athens, Greece mdimop@med.uoa.gr.
authors.forename: M A
authors.initials: MA
authors.lastname: Dimopoulos
authors.affiliation: Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Sonneveld
authors.affiliation: John Theurer Cancer Center, Hackensack, USA.
authors.forename: D
authors.initials: D
authors.lastname: Siegel
authors.affiliation: Myeloma Unit, Division of Hematology, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Palumbo
authors.affiliation: Centre of Applied Medical Research, Clinica Universidad de Navarra, Navarra, Spain.
authors.forename: J
authors.initials: J
authors.lastname: San-Miguel
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000379:methods; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy*; D009842:Oligopeptides / Q000627:therapeutic use*; D012307:Risk Factors; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D009842:Oligopeptides; D013792:Thalidomide; C524865:carfilzomib; C467566:pomalidomide
keywords: carfilzomib; multiple myeloma; pomalidomide