title: Carfilzomib-containing combinations as frontline therapy for multiple myeloma: A meta-analysis of 13 trials.
abstract: OBJECTIVE
  To investigate the activity and safety of carfilzomib-containing combinations as frontline therapy for multiple myeloma.
  
  
  METHODS
  We searched published carfilzomib reports for newly diagnosed multiple myeloma.
  
  
  RESULTS
  Thirteen trials were identified, covering 704 subjects. Pooled analysis showed that carfilzomib combinations as frontline therapy for multiple myeloma attained an impressive at least complete response (≥CR) rate of 21%, at least very good partial response (≥VGPR) rate of 68%, overall response rate (ORR) of 94%. The ≥CR rates of 18% pre-SCT were increased to 43% of post-ASCT, and 64% of postconsolidation (P<.001). For those patients receiving carfilzomib therapy, response quality improved further over time (≥CR rates of 10% after 2nd cycle, 20% after 4th cycle, 43% after 8th cycle; ≥VGPR of 29% after 2nd cycle, 68% after 4th cycle, 88% after 8th cycle). ≥CR rates of 49% from CFZ-LEN-DEX triplet regimen were higher than 18% from CFZ-CYC-DEX triplet regimen and 21% from CFZ-THA-DEX triplet regimen (P=.03).
  
  
  CONCLUSIONS
  Carfilzomib combinations could produce clinical benefits in newly diagnosed patients with multiple myeloma. High-quality response rate could be further improved through ASCT, consolidation therapy, and more cycles of chemotherapy even in the era of carfilzomib. CFZ-LEN-DEX could be a good combination regimen.
authors.affiliation: Department of Hematology, Weifang People's Hospital, Weifang, China.
authors.forename: Zhixin
authors.identifier: http://orcid.org/0000-0001-9986-7875
authors.initials: Z
authors.lastname: Sheng
authors.affiliation: Department of Occupational Disease, Weifang People's Hospital, Weifang, China.
authors.forename: Guifang
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Respiration, Weifang People's Hospital, Weifang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.affiliation: Department of Infection, Weifang People's Hospital, Weifang, China.
authors.forename: Yanju
authors.initials: Y
authors.lastname: Liu
authors.affiliation: E.N.T. department, Weifang People's Hospital, Weifang, China.
authors.forename: Lida
authors.initials: L
authors.lastname: Wang
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D017321:Clinical Trials, Phase I as Topic; D017322:Clinical Trials, Phase II as Topic; D003907:Dexamethasone / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D000077269:Lenalidomide; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000473:pathology / Q000628:therapy*; D009842:Oligopeptides / Q000627:therapeutic use*; D012074:Remission Induction; D033581:Stem Cell Transplantation; D013792:Thalidomide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D009842:Oligopeptides; D013792:Thalidomide; C524865:carfilzomib; D003907:Dexamethasone; D000077269:Lenalidomide
keywords: carfilzomib; frontline; meta-analysis; multiple myeloma