Efficacy and safety of carfilzomib regimens in multiple myeloma patients relapsing after autologous stem cell transplant

ASPIRE and ENDEAVOR outcomes

P. Hari, M. V. Mateos, Rafat Abonour, S. Knop, W. Bensinger, H. Ludwig, K. Song, R. Hajek, P. Moreau, D. S. Siegel, S. Feng, M. Obreja, S. K. Aggarwal, K. Iskander, H. Goldschmidt

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Autologous stem cell transplantation (ASCT) is a standard treatment for eligible multiple myeloma (MM) patients, but many patients will relapse after ASCT and require subsequent therapy. The proteasome inhibitor carfilzomib is approved for relapsed or refractory MM (RRMM). In phase 3 trials, carfilzomib-based regimens (ASPIRE, carfilzomib-lenalidomide-dexamethasone; ENDEAVOR, carfilzomib-dexamethasone) demonstrated superior progression-free survival (PFS) compared with standard therapies for RRMM (ASPIRE: lenalidomide-dexamethasone; ENDEAVOR, bortezomib-dexamethasone). This subgroup analysis of ASPIRE and ENDEAVOR evaluated outcomes according to prior ASCT status. In total, 446 patients in ASPIRE and 538 in ENDEAVOR had prior ASCT. Median PFS was longer for carfilzomib-based regimens vs non-carfilzomib-based regimens for patients with prior ASCT (ASPIRE: 26.3 vs 17.8 months (hazard ratio (HR)=0.68); ENDEAVOR: not estimable vs 10.2 months (HR=0.61)), those with one prior line of therapy that included ASCT (ASPIRE: 29.7 vs 17.8 months (HR=0.70); ENDEAVOR: not estimable vs 11.2 months (HR=0.46)), and those without prior ASCT (ASPIRE: 26.4 vs 16.6 months (HR=0.76); ENDEAVOR: 17.7 vs 8.5 months (HR=0.43)). Overall response rates also favored the carfilzomib-based regimens. No new safety signals were detected. This analysis suggests that carfilzomib-based treatment may lead to improvement in PFS and response rates regardless of prior transplant status. Further evaluation is warranted.

Original languageEnglish (US)
Pages (from-to)2630-2641
Number of pages12
JournalLeukemia
Volume31
Issue number12
DOIs
StatePublished - Dec 1 2017

Fingerprint

Stem Cell Transplantation
Multiple Myeloma
Stem Cells
Transplants
Safety
Dexamethasone
Disease-Free Survival
Therapeutics
Proteasome Inhibitors
carfilzomib
Survival Rate
Recurrence

ASJC Scopus subject areas

  • Hematology
  • Cancer Research
  • Anesthesiology and Pain Medicine

Cite this

Efficacy and safety of carfilzomib regimens in multiple myeloma patients relapsing after autologous stem cell transplant : ASPIRE and ENDEAVOR outcomes. / Hari, P.; Mateos, M. V.; Abonour, Rafat; Knop, S.; Bensinger, W.; Ludwig, H.; Song, K.; Hajek, R.; Moreau, P.; Siegel, D. S.; Feng, S.; Obreja, M.; Aggarwal, S. K.; Iskander, K.; Goldschmidt, H.

In: Leukemia, Vol. 31, No. 12, 01.12.2017, p. 2630-2641.

Research output: Contribution to journalArticle

Hari, P, Mateos, MV, Abonour, R, Knop, S, Bensinger, W, Ludwig, H, Song, K, Hajek, R, Moreau, P, Siegel, DS, Feng, S, Obreja, M, Aggarwal, SK, Iskander, K & Goldschmidt, H 2017, 'Efficacy and safety of carfilzomib regimens in multiple myeloma patients relapsing after autologous stem cell transplant: ASPIRE and ENDEAVOR outcomes', Leukemia, vol. 31, no. 12, pp. 2630-2641. https://doi.org/10.1038/leu.2017.122
Hari, P. ; Mateos, M. V. ; Abonour, Rafat ; Knop, S. ; Bensinger, W. ; Ludwig, H. ; Song, K. ; Hajek, R. ; Moreau, P. ; Siegel, D. S. ; Feng, S. ; Obreja, M. ; Aggarwal, S. K. ; Iskander, K. ; Goldschmidt, H. / Efficacy and safety of carfilzomib regimens in multiple myeloma patients relapsing after autologous stem cell transplant : ASPIRE and ENDEAVOR outcomes. In: Leukemia. 2017 ; Vol. 31, No. 12. pp. 2630-2641.
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abstract = "Autologous stem cell transplantation (ASCT) is a standard treatment for eligible multiple myeloma (MM) patients, but many patients will relapse after ASCT and require subsequent therapy. The proteasome inhibitor carfilzomib is approved for relapsed or refractory MM (RRMM). In phase 3 trials, carfilzomib-based regimens (ASPIRE, carfilzomib-lenalidomide-dexamethasone; ENDEAVOR, carfilzomib-dexamethasone) demonstrated superior progression-free survival (PFS) compared with standard therapies for RRMM (ASPIRE: lenalidomide-dexamethasone; ENDEAVOR, bortezomib-dexamethasone). This subgroup analysis of ASPIRE and ENDEAVOR evaluated outcomes according to prior ASCT status. In total, 446 patients in ASPIRE and 538 in ENDEAVOR had prior ASCT. Median PFS was longer for carfilzomib-based regimens vs non-carfilzomib-based regimens for patients with prior ASCT (ASPIRE: 26.3 vs 17.8 months (hazard ratio (HR)=0.68); ENDEAVOR: not estimable vs 10.2 months (HR=0.61)), those with one prior line of therapy that included ASCT (ASPIRE: 29.7 vs 17.8 months (HR=0.70); ENDEAVOR: not estimable vs 11.2 months (HR=0.46)), and those without prior ASCT (ASPIRE: 26.4 vs 16.6 months (HR=0.76); ENDEAVOR: 17.7 vs 8.5 months (HR=0.43)). Overall response rates also favored the carfilzomib-based regimens. No new safety signals were detected. This analysis suggests that carfilzomib-based treatment may lead to improvement in PFS and response rates regardless of prior transplant status. Further evaluation is warranted.",
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