Carfilzomib: new treatment for multiple myeloma

Carfilzomib (Kyprolis) in combination with lenalidomide and dexamethasone is indicated for the treatment of multiple myeloma in adults who have received at least one prior therapy.

Carfilzomib is given by intravenous infusion together with oral lenalidomide and intravenous dexamethasone. | SCIENCE PHOTO LIBRARY
Carfilzomib is given by intravenous infusion together with oral lenalidomide and intravenous dexamethasone. | SCIENCE PHOTO LIBRARY

Carfilzomib is an irreversible and selective proteasome inhibitor with antiproliferative and proapoptotic activities. 

Administration

Kyprolis is available as a 50ml vial containing 60mg carfilzomib powder for solution for infusion (2mg/ml after reconstitution). It is administered as a 10-minute intravenous infusion on two consecutive days each week for three weeks (days 1, 2, 8, 9, 15 and 16), followed by a 12-day rest period (days 17-28). Each 28-day period comprises one treatment cycle. From cycle 13, the day 8 and 9 doses of Kyprolis are omitted. The starting dose is 20mg/m2 on days 1 and 2 of cycle 1, increasing to 27mg/m2 (max 60mg) on day 8 of cycle 1 if tolerated.

Further information
View Kyprolis drug record
Summary of Product Characteristics
Manufacturer: Amgen

Clinical evidence

The randomised, open-label ASPIRE study compared carfilzomib plus lenalidomide and dexamethasone with lenalidomine and dexamethasone alone (control group) in 792 patients with relapsed multiple myeloma.

Carfilzomib treatment was administered for a maximum of 18 cycles unless discontinued early for disease progression or unacceptable toxicity.

Progression-free survival (PFS, primary endpoint) was significantly greater in patients treated with carfilzomib with a median PFS of 26.3 months vs 17.6 months in the control group (hazard ratio for progression or death 0.69 [95% CI 0.57–0.83; p<0.0001]).

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