Feasibility, Tolerability and Efficacy of Carfilzomib in Combination with Lenalidomide and Dexamethasone in Relapsed Refractory Myeloma Patients: A Retrospective Real-Life Survey of the Sicilian Myeloma Network

被引：25

作者：

Conticello, Concetta ^{[1
]}

Romano, Alessandra ^{[1
]}

Del Fabro, Vittorio ^{[1
]}

Martino, Enrica Antonia ^{[1
]}

Calafiore, Valeria ^{[1
]}

Sapienza, Giuseppe ^{[1
]}

Leotta, Valerio ^{[1
]}

Parisi, Marina Silvia ^{[1
]}

Markovic, Uros ^{[1
]}

Garibaldi, Bruno ^{[1
]}

Leotta, Salvatore ^{[1
]}

Cotzia, Emilia ^{[2
]}

Innao, Vanessa ^{[3
]}

Mannina, Donato ^{[4
]}

Neri, Santo ^{[4
]}

Musso, Maurizio ^{[5
]}

Scalone, Renato ^{[5
]}

Cangialosi, Clotilde ^{[6
]}

Acquaviva, Francesco ^{[6
]}

Cardinale, Giovanni ^{[7
]}

Merenda, Anxur ^{[7
]}

Maugeri, Cinzia ^{[8
]}

Uccello, Giuseppina ^{[9
]}

Poidomani, Massimo ^{[10
]}

Longo, Giuseppe ^{[11
]}

Carlisi, Melania ^{[12
]}

Tibullo, Daniele ^{[13
]}

Di Raimondo, Francesco ^{[1
]}

机构：

[1] Univ Catania, Div Hematol, Azienda Policlin OVE, I-95125 Catania, Italy

[2] UOC Ematol, I-96100 Siracusa, Italy

[3] Univ Messina, Policlin G Martino, Div Hematol, Dipartimento Patol Umana Adulto & Eta Evolut, I-98122 Messina, Italy

[4] Azienda Osped Papardo, UOC Ematol, I-98158 Messina, Italy

[5] UOC OncoEmatol & TMO, Dipartimento Oncol, I-90146 Palermo, Italy

[6] AO Osped Riuniti Villa Sofia Cervello, UOC Ematol, I-90146 Palermo, Italy

[7] ARNAS Civ Cristina Benfratelli, UOC Ematol, I-90147 Palermo, Italy

[8] St Elia Hosp, Div Hematol, I-93100 Caltanissetta, Italy

[9] ARNAS Garibaldi, UOC Ematol, I-95122 Catania, Italy

[10] ASP7, SIMT Hematol, I-97100 Ragusa, Italy

[11] Osped San Vincenzo, UOC Ematol, I-98039 Taormina, ME, Italy

[12] Policlin P Giaccone, UOC Ematol, I-90127 Palermo, Italy

[13] Univ Catania, Dept Biomed & Biotechnol Sci, I-95125 Catania, Italy

来源：

JOURNAL OF CLINICAL MEDICINE | 2019年 / 8卷 / 06期

关键词：

KRd regimen; multiple myeloma; salvage therapy; DIAGNOSED MULTIPLE-MYELOMA; BORTEZOMIB; MULTICENTER; MELPHALAN; SURVIVAL; THERAPY; MAINTENANCE; DARATUMUMAB; PREDNISONE; CRITERIA;

D O I：

10.3390/jcm8060877

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: The ASPIRE (NCT01080391) phase 3 trial showed the efficacy of carfilzomib, lenalidomide and dexamethasone (KRd) triplet for relapse and refractory multiple myeloma (RRMM). However, little is known about safety and efficacy of KRd outside a clinical trial context. Methods: Herein we report real life results of KRd given to 130 RRMM patients from 12 Sicilian Centers. Results: Median age was 62 years; patients had received a median of two previous lines of treatment (range 1-10) and 52% were refractory to previous treatment. Median number of KRd cycles was 12 (2-29), with a mean duration of treatment of 12 months; 21 patients had received at least 18 cycles. Overall response rate was 61%, including 18% complete response. Median PFS was 22.9 months, median OS was not reached. Creatinine clearance >30 mL/min, quality of the best achieved response and standard Fluorescence In Situ Hybridization (FISH) risk were independent predictors of favorable outcome. Patients who received the full-dosage of carfilzomib in the first two cycles had a better outcome. Conclusions: KRd was effective and well tolerated and in a considerable proportion of patients, therapy continued beyond the 18th cycle. The finding of a better outcome in patients with the higher cumulative dose of carfilzomib in the first two cycle encourages to maintain the maximum tolerated dose.

引用

页数：16

共 31 条

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