WEEKLY CARFILZOMIB, LENALIDOMIDE AND DEXAMETHASONE UNTIL PROGRESSION IN RELAPSED REFRACTORY MULTIPLE MYELOMA
Author(s): ,
Cecile Gruchet
Affiliations:
CHU Poitiers,Poitiers,France
,
Valentine Richez
Affiliations:
CHU Nice,Nice,France
,
Stephanie Guidez
Affiliations:
CHU Poitiers,Poitiers,France
,
Cécile Tomowiak
Affiliations:
CHU Poitiers,Poitiers,France
,
Guillemette Fouquet
Affiliations:
CHU Lilles,Lilles,France
,
Antoine Machet
Affiliations:
CHU Poitiers,Poitiers,France
,
Niels Moya
Affiliations:
CHU Poitiers,Poitiers,France
,
Florence Sabirou
Affiliations:
CHU Poitiers,Poitiers,France
,
Anthony Levy
Affiliations:
CHU Poitiers,Poitiers,France
,
Arthur Bobin
Affiliations:
CHU Poitiers,Poitiers,France
,
Helene Gardeney
Affiliations:
CHU Poitiers,Poitiers,France
,
Sabrina Bouyer
Affiliations:
CHU Poitiers,Poitiers,France
,
Franck Bridoux
Affiliations:
CHU Poitiers,Poitiers,France
,
Vincent Javaugue
Affiliations:
CHU Poitiers,Poitiers,France
,
Isabelle Azais
Affiliations:
CHU Poitiers,Poitiers,France
,
Geraldine Durand
Affiliations:
CHU Poitiers,Poitiers,France
,
Herve Avet Loiseau
Affiliations:
CHU Poitiers,Poitiers,France
Xavier Leleu
Affiliations:
CHU Poitiers,Poitiers,France
EHA Library. Gruchet C. Jun 15, 2019; 267023; PS1406
Cecile Gruchet
Cecile Gruchet
Contributions
Abstract

Abstract: PS1406

Type: Poster Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 17:30 - 19:00

Location: Poster area

Background
Carfilzomib, Lenalidomide and Dexamethasone association (KRd) has led to approval in early RRMM. On ASPIRE International phase 3 study Carfilzomib was used on a twice a week basis at 27mg/m2 and limited to 18 months exposure. We have reported already that KRd on a weekly basis at 56 mg/m2 had similar and safe properties. In this abstract we report the long-term exposure data on KRd weekly given at 56 mg/m2 until progression.

Aims
We aimed to evaluate the efficacy of KRd given on a prolong duration beyond 18months, and to validate the safety profile of continuous exposure to Carfilzomib.

Methods
28 patients were prospectively recruited. Carfilzomib 20/56mg/m2 was administered on days 1,8,15 on 28 days cycles. Lenalidomide (25mg/day) was given 21/28 days and Dexamethasone was administered weekly. Patients were treated until progression.

Results
With a median follow-up at start of KRd of 30 months, 50% of patients relapsed and 39% died. 24/28 patients received 1 prior line of treatment. 8/28 patients are still on treatment with duration > 24 month and 6/28 with duration > 30 months. The median number of cycles was 15. ORR and CBR was 85.7% and 89.3%, whom 46% ≥ CR ; with a median DOR of 13 months and 43% having more than 18 months. 6 patients had negative MRD at 10-6 and normalized PET CT. Median of OS is not reached, and the 30 month-expected OS from the start of KRd was 56%. The median PFS and EFS was at 29 months, and the 30 month-expected PFS and EFS was 45%. PFS and EFS being superimposable speaks to that there was no safety concern related to prolonged exposure to K. Only 4 patients stopped KRd for safety issues. Hematologic and non-hematologic adverse events ≥ grade 3 were reported in 16/28 and 10/28 patients. Adverse events ≥ grade 3 seen in ≥10% of patients were neutropenia, thrombocytopenia, vomiting and pyrexia. Of note, 5 patients (18%) were ³65 years old and these patients showed similar data compared to the studied cohort.

Conclusion
KRd weekly at 20/56mg/m2 is effective and safe to early RRMM patients, provides improved safety profile to patients allowing treating patients until progression. Further studies are warranted to confirm this data on a larger early RRMM population and validate the concept of long duration of treatment using Carfilzomib combination.

Session topic: 14. Myeloma and other monoclonal gammopathies - Clinical

Keyword(s): Myeloma, Progression, Refractory, Relapse

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