title: Efficacy and safety of salvage therapy using Carfilzomib for relapsed or refractory multiple myeloma patients: a multicentre retrospective observational study.
abstract: Carfilzomib has been established in previous years as a treatment for patients with relapsed and/or refractory multiple myeloma (RR-MM). A retrospective multicentre study to evaluate the clinical use of carfilzomib for RR-MM outside of a clinical trial setting was conducted by our group. One hundred and thirty-five patients were included. All patients had been previously exposed to bortezomib and 93% had also been treated with lenalidomide. The vast majority of patients received carfilzomib as part of a two- or three-drug combination. The overall response rate was 47·2%. Multivariate analysis revealed bortezomib resistance, lenalidomide resistance and albumin <35 g/l to negatively impact the likelihood of achieving response. The median duration of response was 8·4 months, and was significantly higher in patients receiving three-drug combination and patients presenting without extramedullary disease. The median progression-free survival and overall survival for the entire cohort was 4·9 months (95% confidence interval [CI] 3·8-6·4) and 12·2 months (95% CI 9-not reached), respectively. Toxicity was manageable, although treatment-related death was seen in 5% of patients. In the setting of progressive multiple myeloma, carfilzomib in a combination regimens yields effective results with a manageable toxicity.
authors.affiliation: Institute of Haematology, Rabin Medical Centre, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Eli
authors.initials: E
authors.lastname: Muchtar
authors.affiliation: Department of Haematology, Hadassah Medical Centre, Jerusalem, Israel.
authors.forename: Moshe E
authors.initials: ME
authors.lastname: Gatt
authors.affiliation: Department of Haematology, Soroka University Medical Centre, Negev Beer Sheva, Israel.
authors.forename: Ory
authors.initials: O
authors.lastname: Rouvio
authors.affiliation: Department of Haematology, Shaare Zedek Medical Centre, Jerusalem, Israel.
authors.forename: Chezi
authors.initials: C
authors.lastname: Ganzel
authors.affiliation: Department of Haematology, HaEmek Medical Centre, Afula, Israel.
authors.forename: Evgeni
authors.initials: E
authors.lastname: Chubar
authors.affiliation: Department of Haematology, Galilee Medical Centre, Nahariya, Israel.
authors.forename: Celia
authors.initials: C
authors.lastname: Suriu
authors.affiliation: Haematology Unit, Bnai-Zion Medical Centre, Haifa, Israel.
authors.forename: Tamar
authors.initials: T
authors.lastname: Tadmor
authors.affiliation: Department of Haematology, Kaplan Medical Centre, Rehovot, Israel.
authors.forename: Olga
authors.initials: O
authors.lastname: Shevetz
authors.affiliation: Department of Haematology, Rambam Health Care Campus, Haifa, Israel.
authors.forename: Noa
authors.initials: N
authors.lastname: Lavi
authors.affiliation: Statistical unit, Research department, Rabin Medical Centre, Petah-Tikva, Israel.
authors.forename: Tzippy
authors.initials: T
authors.lastname: Shochat
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.|Department of Haematology, Sorasky Medical Centre, Tel Aviv, Israel.
authors.forename: Yael C
authors.initials: YC
authors.lastname: Cohen
authors.affiliation: Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.|Department of Haematology, Sorasky Medical Centre, Tel Aviv, Israel.
authors.forename: Irit
authors.initials: I
authors.lastname: Avivi
authors.affiliation: Institute of Haematology, Rabin Medical Centre, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Pia
authors.initials: P
authors.lastname: Raanani
authors.affiliation: Institute of Haematology, Rabin Medical Centre, Petah Tikva, Israel.|Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Israel.
authors.forename: Hila
authors.initials: H
authors.lastname: Magen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000473:pathology; D009367:Neoplasm Staging; D009842:Oligopeptides / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D061988:Proteasome Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012008:Recurrence; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D009842:Oligopeptides; D061988:Proteasome Inhibitors; C524865:carfilzomib
keywords: carfilzomib; myeloma; relapse; resistance