Carfilzomib and dexamethasone (Kd56) vs bortezomib and dexamethasone (Vd) in relapsed or refractory multiple myeloma (RRMM): Updated overall survival (OS), safety, and subgroup analysis of ENDEAVOR.

Authors

null

Robert Z. Orlowski

The University of Texas MD Anderson Cancer Center, Houston, TX

Robert Z. Orlowski , Philippe Moreau , Heinz Ludwig , Albert Oriol Rocafiguera , Wee Joo Chng , Hartmut Goldschmidt , Zhao Yang , Amy Kimball , Meletios A. Dimopoulos

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, University Hospital Hotel-Dieu, Nantes, France, Wilhelminen Cancer Research Institute, Wilhelminenspital, Vienna, Austria, Institut Catala d’Oncologia, Hospital Germans Trias i Pujol, Barcelona, Spain, National University Cancer Institute, Singapore, Singapore, Heidelberg University, Heidelberg, Germany, Amgen, Inc., Thousand Oaks, CA, University Athens School of Medicine, Athens, Greece

Research Funding

Pharmaceutical/Biotech Company

Background: The phase 3 ENDEAVOR trial demonstrated significantly improved PFS and OS with Kd56 vs Vd in RRMM patients (pts; Dimopoulos Lancet Oncol 2016 and 2017). We report updated data after additional follow-up. Methods: Hazard ratios (HRs) and 95% CIs were estimated using stratified or unstratified Cox proportional hazards models for primary and subgroup OS analyses, respectively. Results: 929 pts were randomized (Kd56, n = 464; Vd, n = 465). As of 19-Jul-17, median OS was 47.8 (Kd56) vs 38.8 (Vd) months (mos; HR, 0.76 [95% CI, 0.633–0.915]; median follow-up, 44.3 vs 43.7 mos). OS was longer with Kd56 vs Vd within age subgroups ( < 65 years [yrs]: median, 47.8 vs 42.2 mos; HR, 0.79 [95% CI, 0.598–1.031]; 65–74 yrs: median, 49.0 vs 36.2 mos; HR, 0.71 [95% CI, 0.520–0.958]; ≥75 yrs: median, 36.1 vs 23.9 mos; HR, 0.78 [95% CI, 0.506–1.199]). OS was longer with Kd56 vs Vd by prior lines of therapy (1 line: median, 51.3 vs 43.7 mos; HR, 0.77 [95% CI, 0.583–1.018]; 2–3 lines: median, 39.5 vs 28.4 mos; HR, 0.75 [95% CI, 0.589–0.959]) and prior bortezomib (btz) exposure (prior btz: median, 41.8 vs 32.7 mos; HR, 0.85 [95% CI, 0.669–1.082; no prior btz: median, not estimable [NE] vs 42.2 mos; HR, 0.66 [95% CI, 0.496–0.875]). OS was longer with Kd56 vs Vd for high-risk (median, 28.0 vs 22.7 mos; HR, 0.81 [95% CI, 0.580–1.136]) and standard-risk (median, NE vs 43.5 mos; HR, 0.79 [95% CI, 0.618–1.009]) cytogenetics pts. 457 (98.7%, Kd56) and 451 (98.9%, Vd) pts had an adverse event (AE); 379 (81.9%, Kd56) and 324 (71.1%, Vd) had a grade ≥3 AE. Exposure-adjusted pt incidences per 100 pt-yrs (95% CI) of AEs were 1352.07 (1233.62–1481.89) for Kd56 and 1754.86 (1600.15–1924.53) for Vd; for grade ≥3 AEs, these values were 162.31 (146.77–179.50) and 175.90 (157.75–196.13). The most common AEs in the Kd arm (≥ 30% of subjects) were anemia (43.6%), diarrhea (36.7%), pyrexia (32.6%), hypertension (32.4%), fatigue (32.2%) and dyspnea (32.2%). Conclusions: With median follow-up of ~44 mos, clinically meaningful OS improvements were observed with Kd56 vs Vd, including in all subgroups examined. The Kd56 safety profile was consistent with previous analyses. Clinical trial information: NCT01568866

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Abstract Details

Meeting

2018 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Hematologic Malignancies—Plasma Cell Dyscrasia

Track

Hematologic Malignancies—Plasma Cell Dyscrasia

Sub Track

Multiple Myeloma

Clinical Trial Registration Number

NCT01568866

Citation

J Clin Oncol 36, 2018 (suppl; abstr 8032)

DOI

10.1200/JCO.2018.36.15_suppl.8032

Abstract #

8032

Poster Bd #

41

Abstract Disclosures