Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma: A systematic review

Adeela Mushtaq, Vikas Kapoor, Azka Latif, Ahmad Iftikhar, Umar Zahid, Ali McBride, Ivo L Abraham, Irbaz Bin Riaz, Faiz - Anwer

Research output: Contribution to journalReview article

7 Citations (Scopus)

Abstract

Standard induction therapy for multiple myeloma is three-drug combination based on following classes of drugs: proteasome inhibitors, immunomodulators and steroids. Despite its notable efficacy, bortezomib has side effects like peripheral neuropathy (PNP) with reported incidence of grade ≥3 PNP between 2%–23% Schlafer et al., 2017. Carfilzomib (CFZ) has high selectivity and minimal off-target adverse effects including lower rates of PNP. CFZ is already approved for treatment of relapsed and refractory multiple myeloma (RRMM) as single agent as well as in combination with lenalidomide and/or dexamethasone. Extensive literature search identified a total of 1839 articles. Twenty-six articles (n = 5980) met the inclusion criteria, 15 in newly diagnosed multiple myeloma (NDMM) and 11 in RRMM group. CFZ demonstrates comparable or even better efficacy to bortezomib with much favorable AE profile. Deep, rapid and sustainable response using KRd with safer toxicity profile supports extension of KRd therapy to frontline therapy for all risk categories of MM. High incidence of grade ≥3 HTN underscores the importance of serial BP monitoring. In RRMM, CFZ has documented efficacy with standard 20–27mg/m2 dose. Further large-scale trials are needed to study benefit-to-risk profile of 20–56 and 20–70 mg/m2 dose of CFZ vs standard 20–27 mg/m2 dose in NDMM and RRMM.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalCritical Reviews in Oncology/Hematology
Volume125
DOIs
StatePublished - May 1 2018

Fingerprint

Multiple Myeloma
Peripheral Nervous System Diseases
Proteasome Inhibitors
carfilzomib
Incidence
Immunologic Factors
Drug Combinations
Dexamethasone
Therapeutics
Steroids
Pharmaceutical Preparations

Keywords

  • Bortezomib
  • Carfilzomib
  • Multiple myeloma
  • Proteasome inhibitor

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Geriatrics and Gerontology

Cite this

Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma : A systematic review. / Mushtaq, Adeela; Kapoor, Vikas; Latif, Azka; Iftikhar, Ahmad; Zahid, Umar; McBride, Ali; Abraham, Ivo L; Riaz, Irbaz Bin; Anwer, Faiz -.

In: Critical Reviews in Oncology/Hematology, Vol. 125, 01.05.2018, p. 1-11.

Research output: Contribution to journalReview article

Mushtaq, Adeela ; Kapoor, Vikas ; Latif, Azka ; Iftikhar, Ahmad ; Zahid, Umar ; McBride, Ali ; Abraham, Ivo L ; Riaz, Irbaz Bin ; Anwer, Faiz -. / Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma : A systematic review. In: Critical Reviews in Oncology/Hematology. 2018 ; Vol. 125. pp. 1-11.
@article{9813f973194f4974b1e44baef37cedfd,
title = "Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma: A systematic review",
abstract = "Standard induction therapy for multiple myeloma is three-drug combination based on following classes of drugs: proteasome inhibitors, immunomodulators and steroids. Despite its notable efficacy, bortezomib has side effects like peripheral neuropathy (PNP) with reported incidence of grade ≥3 PNP between 2{\%}–23{\%} Schlafer et al., 2017. Carfilzomib (CFZ) has high selectivity and minimal off-target adverse effects including lower rates of PNP. CFZ is already approved for treatment of relapsed and refractory multiple myeloma (RRMM) as single agent as well as in combination with lenalidomide and/or dexamethasone. Extensive literature search identified a total of 1839 articles. Twenty-six articles (n = 5980) met the inclusion criteria, 15 in newly diagnosed multiple myeloma (NDMM) and 11 in RRMM group. CFZ demonstrates comparable or even better efficacy to bortezomib with much favorable AE profile. Deep, rapid and sustainable response using KRd with safer toxicity profile supports extension of KRd therapy to frontline therapy for all risk categories of MM. High incidence of grade ≥3 HTN underscores the importance of serial BP monitoring. In RRMM, CFZ has documented efficacy with standard 20–27mg/m2 dose. Further large-scale trials are needed to study benefit-to-risk profile of 20–56 and 20–70 mg/m2 dose of CFZ vs standard 20–27 mg/m2 dose in NDMM and RRMM.",
keywords = "Bortezomib, Carfilzomib, Multiple myeloma, Proteasome inhibitor",
author = "Adeela Mushtaq and Vikas Kapoor and Azka Latif and Ahmad Iftikhar and Umar Zahid and Ali McBride and Abraham, {Ivo L} and Riaz, {Irbaz Bin} and Anwer, {Faiz -}",
year = "2018",
month = "5",
day = "1",
doi = "10.1016/j.critrevonc.2018.02.008",
language = "English (US)",
volume = "125",
pages = "1--11",
journal = "Critical Reviews in Oncology/Hematology",
issn = "1040-8428",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Efficacy and toxicity profile of carfilzomib based regimens for treatment of multiple myeloma

T2 - A systematic review

AU - Mushtaq, Adeela

AU - Kapoor, Vikas

AU - Latif, Azka

AU - Iftikhar, Ahmad

AU - Zahid, Umar

AU - McBride, Ali

AU - Abraham, Ivo L

AU - Riaz, Irbaz Bin

AU - Anwer, Faiz -

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Standard induction therapy for multiple myeloma is three-drug combination based on following classes of drugs: proteasome inhibitors, immunomodulators and steroids. Despite its notable efficacy, bortezomib has side effects like peripheral neuropathy (PNP) with reported incidence of grade ≥3 PNP between 2%–23% Schlafer et al., 2017. Carfilzomib (CFZ) has high selectivity and minimal off-target adverse effects including lower rates of PNP. CFZ is already approved for treatment of relapsed and refractory multiple myeloma (RRMM) as single agent as well as in combination with lenalidomide and/or dexamethasone. Extensive literature search identified a total of 1839 articles. Twenty-six articles (n = 5980) met the inclusion criteria, 15 in newly diagnosed multiple myeloma (NDMM) and 11 in RRMM group. CFZ demonstrates comparable or even better efficacy to bortezomib with much favorable AE profile. Deep, rapid and sustainable response using KRd with safer toxicity profile supports extension of KRd therapy to frontline therapy for all risk categories of MM. High incidence of grade ≥3 HTN underscores the importance of serial BP monitoring. In RRMM, CFZ has documented efficacy with standard 20–27mg/m2 dose. Further large-scale trials are needed to study benefit-to-risk profile of 20–56 and 20–70 mg/m2 dose of CFZ vs standard 20–27 mg/m2 dose in NDMM and RRMM.

AB - Standard induction therapy for multiple myeloma is three-drug combination based on following classes of drugs: proteasome inhibitors, immunomodulators and steroids. Despite its notable efficacy, bortezomib has side effects like peripheral neuropathy (PNP) with reported incidence of grade ≥3 PNP between 2%–23% Schlafer et al., 2017. Carfilzomib (CFZ) has high selectivity and minimal off-target adverse effects including lower rates of PNP. CFZ is already approved for treatment of relapsed and refractory multiple myeloma (RRMM) as single agent as well as in combination with lenalidomide and/or dexamethasone. Extensive literature search identified a total of 1839 articles. Twenty-six articles (n = 5980) met the inclusion criteria, 15 in newly diagnosed multiple myeloma (NDMM) and 11 in RRMM group. CFZ demonstrates comparable or even better efficacy to bortezomib with much favorable AE profile. Deep, rapid and sustainable response using KRd with safer toxicity profile supports extension of KRd therapy to frontline therapy for all risk categories of MM. High incidence of grade ≥3 HTN underscores the importance of serial BP monitoring. In RRMM, CFZ has documented efficacy with standard 20–27mg/m2 dose. Further large-scale trials are needed to study benefit-to-risk profile of 20–56 and 20–70 mg/m2 dose of CFZ vs standard 20–27 mg/m2 dose in NDMM and RRMM.

KW - Bortezomib

KW - Carfilzomib

KW - Multiple myeloma

KW - Proteasome inhibitor

UR - http://www.scopus.com/inward/record.url?scp=85042747371&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042747371&partnerID=8YFLogxK

U2 - 10.1016/j.critrevonc.2018.02.008

DO - 10.1016/j.critrevonc.2018.02.008

M3 - Review article

C2 - 29650268

AN - SCOPUS:85042747371

VL - 125

SP - 1

EP - 11

JO - Critical Reviews in Oncology/Hematology

JF - Critical Reviews in Oncology/Hematology

SN - 1040-8428

ER -