Dr. Costello on Determining Proper Dosing of Carfilzomib in Relapsed/Refractory Myeloma

Caitlin Costello, MD, an associate clinical professor of medicine at the University of California, San Diego, discusses proper dosing of carfilzomib (Kyprolis) in relapsed/refractory multiple myeloma.

The role of carfilzomib in the myeloma space is evolving, says Costello. The agent was originally evaluated with great concern for tumor lysis, renal failure, and cardiac toxicity. Its initial place in the relapsed/refractory setting has started to shift, and it is now being investigated in the newly diagnosed setting. Carfilzomib is also being investigated in high-risk patients, as well as in those with smoldering multiple myeloma, adds Costello. While the field does not quite know yet the proper dosing of carfilzomib, it is being evaluated in many different areas.

The phase 3 ARROW study was an opportunity to find a way to administer carfilzomib in a way that is more convenient for patients. Carfilzomib is a good drug that many patients with relapsed/refractory myeloma receive—sometimes in the up-front setting—but it has a challenging schedule for patients in that they have to receive it twice weekly. As physicians have gotten more comfortable with prescribing it, they have been able to better understand the appropriate ways to administer carfilzomib to mitigate some of those adverse events, concludes Costello.