Carfilzomib, lenalidomide, and dexamethasone in relapsed refractory multiple myeloma: a prospective real-life experience of the Regional Tuscan Myeloma Network.

Autor:	Antonioli E; Haematology Unit, Careggi University Hospital, Florence, Italy., Pilerci S; Haematology Unit, Careggi University Hospital, Florence, Italy., Attucci I; Haematology Unit, Careggi University Hospital, Florence, Italy., Buda G; Department of Clinical and Experimental Medicine, Hematology, University of Pisa, Pisa, Italy., Gozzetti A; Hematology, Department of Medical Science, Surgery and Neuroscience, University of Siena, Siena, Italy., Candi V; U.O.S Ematologia, San Donato Hospital, Arezzo, Italy., Simonetti F; U.O.S. Ematologia-Ospedale Versilia, Lido Di Camaiore, Viareggio, Italy., Giudice MLD; Department of Clinical and Experimental Medicine, Hematology, University of Pisa, Pisa, Italy., Ciofini S; Hematology, Department of Medical Science, Surgery and Neuroscience, University of Siena, Siena, Italy., Staderini M; S.O.S. Oncoematologia ed Ematologia Clinica, Ospedale Nuovo San Giovanni di Dio - USL Toscana Centro, Florence, Italy., Grammatico S; S.O.S. Oncoematologia, Ospedale Santo Stefano, Prato, Italy., Buzzichelli A; Haematology Unit, Careggi University Hospital, Florence, Italy., Messeri M; Haematology Unit, Careggi University Hospital, Florence, Italy., Bocchia M; Hematology, Department of Medical Science, Surgery and Neuroscience, University of Siena, Siena, Italy., Galimberti S; Department of Clinical and Experimental Medicine, Hematology, University of Pisa, Pisa, Italy., Vannucchi AM; Haematology Unit, Careggi University Hospital, Florence, Italy.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2023 Apr 25; Vol. 13, pp. 1162990. Date of Electronic Publication: 2023 Apr 25 (Print Publication: 2023).
DOI:	10.3389/fonc.2023.1162990
Abstrakt:	Introduction: Carfilzomib, a potent, irreversible, selective proteasome inhibitor has demonstrated consistent results in relapsed/refractory multiple myeloma (RRMM) combined with lenalidomide and dexamethasone (KRd). No prospective studies are yet available that analyzed the efficacy of the KRd combination. Methods: Herein, we report a multicenter prospective observational study on 85 patients who were treated with KRd combination as the second or third line of treatment, according to standard practice. Results: The median age was 61 years; high-risk cytogenetic was found in 26% and renal impairment (estimated glomerular filtration rate (eGFR) <60 ml/min) in 17%. After a median follow-up of 40 months, patients received a median number of 16 cycles of KRd, with a median duration of treatment (DoT) of 18 months (range, 16.1-19.2 months). The overall response rate was 95%, with a high-quality response (≥very good partial remission [VGPR]) in 57% of the patients. The median progression-free survival (PFS) was 36 months (range, 29.1-43.2 months). Achievement of at least VGPR and a previous autologous stem cell transplantation (ASCT) were associated with longer PFS. The median overall survival (OS) was not reached (NR); the 5-year OS rate was 73%. Nineteen patients underwent KRd treatment as a bridge to autologous transplantation, obtaining a post-transplant minimal residual disease (MRD) negativity in 65% of cases. The most common adverse events were hematological, followed by infection and cardiovascular events, rarely G3 or higher, with a discontinuation rate for toxicities of 6%. Our data confirmed the feasibility and safety of the KRd regimen in real life. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Antonioli, Pilerci, Attucci, Buda, Gozzetti, Candi, Simonetti, Giudice, Ciofini, Staderini, Grammatico, Buzzichelli, Messeri, Bocchia, Galimberti and Vannucchi.)
Databáze:	MEDLINE
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