Weekly carfilzomib, lenalidomide, and dexamethasone (KRd) in relapsed or refractory multiple myeloma (RRMM): A phase 1b study.

Authors

null

Noa Biran

John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ

Noa Biran , David Samuel DiCapua Siegel , Jesus G. Berdeja , Noopur S. Raje , Robert F. Cornell , Melissa Alsina , Tibor Kovacsovics , Belle Fang , Amy Kimball , Carl Ola Landgren

Organizations

John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, Sarah Cannon Research Institute, Nashville, TN, Massachusetts General Hospital Cancer Center, Boston, MA, Vanderbilt University Medical Center, Nashville, TN, Moffitt Cancer Center, Tampa, FL, Huntsman Cancer Institute, Salt Lake City, UT, Amgen, Inc., Thousand Oaks, CA, Memorial Sloan Kettering Cancer Center, New York, NY

Research Funding

Pharmaceutical/Biotech Company

Background: KRd is approved for treatment of RRMM patients (pts). Under the approved KRd regimen, carfilzomib is given twice weekly (20/27 mg/m2; 10-min IV infusion). Here we present updated results from a dose-finding study assessing weekly KRd. Methods: This study consisted of a dose-evaluation component and a dose-expansion component in both RRMM and newly diagnosed MM. Results for RRMM pts are presented here. Two dose levels were evaluated: carfilzomib 56 mg/m2 and carfilzomib 70 mg/m2. All pts received carfilzomib (30-min IV infusion on days [D] 1, 8, and 15; 20 mg/m2 on C1D1), lenalidomide 25 mg (D1–21), and dexamethasone 40 mg (D1, 8, 15, and 22) on a 28-day cycle (dexamethasone was not given on D22 for cycles 9+). Pts in the expansion arm received the selected KRd regimen on the same schedule used for dose evaluation. Response was assessed by investigators. Results: Twenty-two RRMM pts were enrolled in the dose-evaluation part and received study drug (56 mg/m2, n = 10; 70 mg/m2, n = 12). The maximum tolerated dose of carfilzomib was not reached; the 70 mg/m2 dose was selected for dose expansion and 34 additional RRMM pts received this dose. Results are presented for pts who received carfilzomib 56 mg/m2 during dose evaluation (n = 10; median 2 prior regimens [range 1-3]) and for pts who received carfilzomib 70 mg/m2 during dose evaluation or expansion (n = 46; median 1 prior regimen [range 1-5]). Median (mean) average carfilzomib dose was 53.2 (52.8) mg/m2 in the 56 mg/m2 group and 62.4 (61.3) mg/m2 in the 70 mg/m2 group. Pt incidence of grade ≥3 adverse events was 70.0% (56 mg/m2) and 71.7% (70 mg/m2). Pt incidence of carfilzomib discontinuation due to adverse events was 20.0% (56 mg/m2) and 17.4% (70 mg/m2). There were three total deaths in the 70 mg/m2 group (one each due to cardiac arrest, cardiac disorder, and progressive disease). Overall response rates were 90.0% (56 mg/m2) and 89.1% (70 mg/m2); 20.0% (56 mg/m2) and 30.4% (70 mg/m2) of pts achieved a complete response (CR) or stringent CR. Conclusions: Once weekly KRd was effective and had manageable toxicity in pts with RRMM. As a weekly carfilzomib dosing regimen could offer pts greater convenience, these results support further clinical evaluation. Clinical trial information: NCT02335983

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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

NCT02335983

Citation

J Clin Oncol 36, 2018 (suppl; abstr 8022)

DOI

10.1200/JCO.2018.36.15_suppl.8022

Abstract #

8022

Poster Bd #

31

Abstract Disclosures