Outcome of treatment with carfilzomib before and after treatment with daratumumab in relapsed or refractory multiple myeloma patients
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Outcome of treatment with carfilzomib before and after treatment with daratumumab in relapsed or refractory multiple myeloma patients. / Højholt, Karen Louise; Gregersen, Henrik; Szabo, Agoston Gyula; Klausen, Tobias Wirenfeldt; Levring, Mette Bøegh; Preiss, Birgitte; Helleberg, Carsten; Breinholt, Marie Fredslund; Hermansen, Emil; Rahbek Gjerdrum, Lise Mette; Bønløkke, Søren Thorgaard; Nielsen, Katrine; Kjeldsen, Eigil; Iversen, Katrine Fladeland; Teodorescu, Elena Manuela; Kurt, Eva; Strandholdt, Casper; Andersen, Mette Klarskov; Vangsted, Annette Juul.
I: Hematological Oncology, Bind 39, Nr. 4, 2021, s. 521-528.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Outcome of treatment with carfilzomib before and after treatment with daratumumab in relapsed or refractory multiple myeloma patients
AU - Højholt, Karen Louise
AU - Gregersen, Henrik
AU - Szabo, Agoston Gyula
AU - Klausen, Tobias Wirenfeldt
AU - Levring, Mette Bøegh
AU - Preiss, Birgitte
AU - Helleberg, Carsten
AU - Breinholt, Marie Fredslund
AU - Hermansen, Emil
AU - Rahbek Gjerdrum, Lise Mette
AU - Bønløkke, Søren Thorgaard
AU - Nielsen, Katrine
AU - Kjeldsen, Eigil
AU - Iversen, Katrine Fladeland
AU - Teodorescu, Elena Manuela
AU - Kurt, Eva
AU - Strandholdt, Casper
AU - Andersen, Mette Klarskov
AU - Vangsted, Annette Juul
N1 - Publisher Copyright: © 2021 John Wiley & Sons Ltd.
PY - 2021
Y1 - 2021
N2 - Real world evidence is important since most patients cannot be included in randomized clinical trials (RCTs). In a nationwide, cohort of relapsed/refractory multiple myeloma patients treated with daratumumab (N = 635), we retrospective studied patients treated with carfilzomib (N = 251). Data were collected by audit of medical records. We compared characteristics of patients treated with carfilzomib before daratumumab (Car-Da; N = 150) and after daratumumab (Da-Car; N = 101) with those not treated with carfilzomib (N = 384). Furthermore, we examined effectiveness and safety of carfilzomib. The group of patients treated with carfilzomib differed from patients not treated with carfilzomib in the following parameters: They were younger, more were treated up-front with high dose melphalan and autologous stem cell transplantation (HDM-ASCT)and had relapse within 18 months thereafter, and more had high-risk cytogenetic abnormalities (CA) and amplification 1q (amp1q). In patients treated with Car-Da, 30.3% had high-risk CA and 30.1% had amp1q and in Da-Car it was 43.3% and 41%, respectively. In the Car-Da cohort, 34.4% experienced early relapse after HDM-ASCT versus 47.4% in the Da-Car cohort. The percentage of patients with very good partial remission was higher in patients treated with Car-Da compared to Da-Car (31.7% vs. 17.4%). The median duration of treatment and time to next treatment (TNT) of Car-Da/Da-Car were 4.6/4.3 months and 7.1/4.3 months and only a trend toward superior TNT for Car-Da was found (p = 0.06). Toxicity of carfilzomib was the same as reported in RCT. A similar poor TNT of daratumumab was found when used before (5.6 months) or after carfilzomib (4.9 months). In this cohort of patients with sequential treatment with carfilzomib and daratumumab or vice versa, a high percentage of patients were high-risk by CA, amp1q, and early relapse after HDM-ASCT. Outcome of Car-DA and outcome of Da-Car were equally poor. These patients should be considered for new promising treatment strategies.
AB - Real world evidence is important since most patients cannot be included in randomized clinical trials (RCTs). In a nationwide, cohort of relapsed/refractory multiple myeloma patients treated with daratumumab (N = 635), we retrospective studied patients treated with carfilzomib (N = 251). Data were collected by audit of medical records. We compared characteristics of patients treated with carfilzomib before daratumumab (Car-Da; N = 150) and after daratumumab (Da-Car; N = 101) with those not treated with carfilzomib (N = 384). Furthermore, we examined effectiveness and safety of carfilzomib. The group of patients treated with carfilzomib differed from patients not treated with carfilzomib in the following parameters: They were younger, more were treated up-front with high dose melphalan and autologous stem cell transplantation (HDM-ASCT)and had relapse within 18 months thereafter, and more had high-risk cytogenetic abnormalities (CA) and amplification 1q (amp1q). In patients treated with Car-Da, 30.3% had high-risk CA and 30.1% had amp1q and in Da-Car it was 43.3% and 41%, respectively. In the Car-Da cohort, 34.4% experienced early relapse after HDM-ASCT versus 47.4% in the Da-Car cohort. The percentage of patients with very good partial remission was higher in patients treated with Car-Da compared to Da-Car (31.7% vs. 17.4%). The median duration of treatment and time to next treatment (TNT) of Car-Da/Da-Car were 4.6/4.3 months and 7.1/4.3 months and only a trend toward superior TNT for Car-Da was found (p = 0.06). Toxicity of carfilzomib was the same as reported in RCT. A similar poor TNT of daratumumab was found when used before (5.6 months) or after carfilzomib (4.9 months). In this cohort of patients with sequential treatment with carfilzomib and daratumumab or vice versa, a high percentage of patients were high-risk by CA, amp1q, and early relapse after HDM-ASCT. Outcome of Car-DA and outcome of Da-Car were equally poor. These patients should be considered for new promising treatment strategies.
KW - carfilzomib
KW - daratumumab
KW - multiple myeloma
KW - real-world evidence
U2 - 10.1002/hon.2906
DO - 10.1002/hon.2906
M3 - Journal article
C2 - 34342035
AN - SCOPUS:85111847498
VL - 39
SP - 521
EP - 528
JO - Hematological Oncology
JF - Hematological Oncology
SN - 0278-0232
IS - 4
ER -
ID: 276388844