Real-World Utilization of Carfilzomib (Once or Twice Weekly) Initiated in Patients After a First Relapse Between 2017 and 2022 in France: An Analysis From a Large-Scale Epidemiology of Multiple MYeloma (EmmY) Cohort
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: Carfilzomib (K) is approved in France to treat multiple myeloma in second line or later (2L+) with dexamethasone (Kd), lenalidomide and dexamethasone (KRd), daratumumab and dexamethasone (D-Kd). We assessed K utilization and outcomes in a French real-world cohort (2017-2022). RESULTS: Overall, 972 patients-initiated K treatment in 2L (21%), 3L (23%) and 4L+ (56%). Patients were largely exposed (96%) and refractory (75%) to immunomodulatory drugs. The most frequent regimens in 2L were KRd (33%) and D-Kd (24%), in 3L were Kd (27%) and K with pomalidomide and dexamethasone (KPd; 27%) and in 4L+ was Kd (49%). Of the 224 elderly patients (≥ 75 years), 45% received Kd in 4L+. Since 2018, KRd and Kd use declined in favor of D-Kd and KPd. The recommended K dose was mostly used despite some variability. In 2022, once-weekly dosing was used in most D-Kd and KRd patients, and half of Kd and KPd patients. Effectiveness of K-based regimens was similar regardless of starting K once-weekly and twice-weekly. Overall response rate (ORR) for KRd in 2L was 81%, with median overall survival (mOS) not reached (NR). ORR for D-Kd was 76% (78% in 2L) and mOS 32.0 months (NR in 2L). For KPd, ORR was 69% with mOS of 26.4 months. For Kd, ORR was 54% in 4L, 51% among elderly patients, and mOS was 15.5 months. CONCLUSIONS: This real-world study confirms carfilzomib effectiveness at both dosing frequencies. K triplets resulted in long survivals and Kd remained satisfactory to treat heavily pretreated patients.
Authors: Cyrille Hulin, Karim Belhadj Merzoug, Bruno Royer, Denis Caillot, Arthur Bobin, Margaret Macro, Lionel Karlin, Mohamad Mohty, Laurent Frenzel, Aurore Perrot, Laure Vincent, Mammoun Dib, Frédérique Orsini Piocell, Riad Benramdane, Claire Calmettes, Thomas Chalopin, Ronan Garlantézec, Gaëlle Désaméricq, Hakima Mechiche, Olivier Decaux
Institutions: Centre Hospitalier Universitaire de Bordeaux, Centre Hospitalier Universitaire Henri-Mondor, Hôpitaux Universitaires Henri-Mondor, Hôpital Saint-Louis, CHU Dijon Bourgogne, Centre Hospitalier Universitaire de Poitiers, Centre Hospitalier Universitaire de Caen Normandie, Hôpital Lyon Sud, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Hôpital Necker-Enfants Malades, Institut universitaire du cancer de Toulouse Oncopole, Centre Hospitalier Universitaire de Montpellier, Centre Hospitalier Universitaire d'Angers, Centre Hospitalier Annecy Genevois, Hôpital NOVO, Université de Tours, Centre Hospitalier Universitaire de Tours, Centre Hospitalier Universitaire de Rennes
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,890
Funder: Amgen
OpenAlex ID: W4413243153