Treatment of Multiple Myeloma - Episode 6

Carfilzomib Combination in Relapsed Multiple Myeloma

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The ASPIRE trial compared carfilzomib, lenalidomide, and dexamethasone with lenalidomide and dexamethasone in relapsed multiple myeloma (MM), describes Sagar Lonial, MD. The median progression-free survival (PFS) was 26.3 with carfilzomib versus 17.6 months without (HR = 0.69; 95% CI, 0.57-0.83; P <.0001). Sundar Jagannath, MD, notes that these results clearly demonstrated that the triple therapy regimen is superior to doublet therapy in a relapsed situation.

In the control arm of the ASPIRE trial, the long remissions seen with lenalidomide and dexamethasone were unprecedented, suggests James R. Berenson, MD. Another outstanding result of ASPIRE was the comparability of the side effect profile between the 2 study arms, suggests Shaji Kumar, MD.

In the FOCUS trial, which was conducted predominantly in Europe, patients were randomized to receive either single agent carfilzomib or cyclophosphamide and prednisone. The 2 arms were similar in PFS and overall survival outcomes, reports Lonial. Each of these agents are associated with unique side effects, panelists note.