International Journal of Hematology

DOI: 10.1007/s12185-019-02754-3 Pages: 57-64

Final results of a phase I study of carfilzomib, lenalidomide, and dexamethasone for heavily pretreated multiple myeloma

1. Toyohashi Municipal Hospital, Division of Hematology and Oncology

2. Japanese Red Cross Medical Center, Department of Hematology

3. Nagoya City University Graduate School of Medical Science, Department of Hematology and Oncology

4. Niigata Cancer Center Hospital, Department of Internal Medicine

5. National Hospital Organization Disaster Medical Center, Department of Hematology

6. National Hospital Organization Okayama Medical Center, Department of Hematology

7. Sapporo Medical University School of Medicine, Department of Gastroenterology, Rheumatology and Clinical Immunology

8. Tochigi Cancer Center, Department of Hematology

9. Tokushima Prefectural Central Hospital, Department of Hematology

10. Ono Pharmaceutical, Department of Oncology Clinical Development Planning

Correspondence to:
Isamu Sugiura
Email: sugiura-isamu@toyohashi-mh.jp

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Abstract

Abstract

We report the final results from a multicenter, open-label phase I study of carfilzomib plus lenalidomide and dexamethasone in Japanese patients with heavily pretreated relapsed and/or refractory multiple myeloma (RRMM). Twenty-six RRMM patients were enrolled and received a median of 4.0 prior regimens; 12/26 patients (46.2%) completed the planned 18 administration cycles (mean number of cycles: 14.5 ± 4.9). The safety profile was consistent with that of previous carfilzomib studies. All patients experienced adverse events (AEs), but no new safety concerns were observed. The most common grade ≥ 3 AEs (incidence: ≥ 10%) were lymphocyte count decreased (46.2%), platelet count decreased (42.3%), and neutrophil count decreased (34.6%). The overall response rate was 88.5% (23/26; 90% confidence interval: 72.8–96.8). Complete response (CR) or better was achieved by 30.8% of patients compared with 3.8% in the interim analysis. The median time to CR or better response was 9.4 months. Median progression-free survival and duration of response were 19.5 months and 20.3 months, respectively. Median overall survival was not reached. Long-term administration of carfilzomib produced deep response and long-term disease control. The combination of carfilzomib plus lenalidomide and dexamethasone was well tolerated and showed promising clinical efficacy for heavily pretreated RRMM patients.

Clinical trial registration

This clinical trial was registered in the database clinicaltrials.jp (clinical trial registration number: Japic CTI 142677).

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