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Phase 2 study of carfilzomib, thalidomide, and low-dose dexamethasone as induction and consolidation in newly diagnosed, transplant eligible patients with multiple myeloma, the carthadex trial

Wester, R., van der Holt, B., Asselbergs, E., Zweegman, S., Kersten, M. J., Vellenga, E., van Marwijk Kooy, M., de Weerdt, O., Minnema, M., Lonergan, S., Palumbo, A., Lokhorst, H., Broijl, A. & Sonneveld, P., 4-Apr-2019, In : Haematologica. 29 p.

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  • Phase 2 Study Of Carfilzomib, Thalidomide, And Low-Dose Dexamethasone As Induction And Consolidation In Newly Diagnosed, Transplant Eligible Patients With Multiple Myeloma, The Carthadex Trial

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DOI

  • Ruth Wester
  • Bronno van der Holt
  • Emelie Asselbergs
  • Sonja Zweegman
  • Marie Jose Kersten
  • Edo Vellenga
  • Marinus van Marwijk Kooy
  • Okke de Weerdt
  • Monique Minnema
  • Sarah Lonergan
  • Antonio Palumbo
  • Henk Lokhorst
  • Annemiek Broijl
  • Pieter Sonneveld

This is a phase 2 dose escalation trial of carfilzomib in combination with thalidomide and dexamethasone for induction and consolidation in transplant-eligible patients with newly diagnosed multiple myeloma. The results of 4 dose levels are reported. Induction therapy consisted of 4 cycles of carfilzomib 20/27 mg/m2 (n=50), 20/36 mg/m2 (n=20), 20/45 mg/m2 (n=21) and 20/56 mg/m2 (n=20) on days 1, 2, 8, 9, 15, 16 of a 28-day cycle; thalidomide 200 mg on day 1 through 28 and dexamethasone 40 mg weekly. Induction therapy was followed by high dose melphalan and autologous stem cell transplantation and consolidation therapy with 4 cycles of carfilzomib, thalidomide and dexamethasone in the same schedule except a lower dose of thalidomide (50 mg). Very good partial response rate or better and complete response rate or better after induction therapy were 65% and 18% respectively, increasing to 86% and 63% respectively after consolidation therapy. In all cohorts combined, after a median follow-up of 58.7 months, median progression-free survival was 58 months (95% CI 45-67 months). Median overall survival was 83 months (95% CI 83 months-not reached). Grade 3/4 adverse events consisted mainly of infections, respiratory disorders, skin and vascular disorders in 11%, 8%, 9%, and 9% respectively. Only in 1 patient grade 3 polyneuropathy was reported. Cardiac events were limited, grade 3/4 in 5% of patients. Carfilzomib, thalidomide and dexamethasone as induction and consolidation treatment after high dose melphalan and autologous stem cell transplantation is highly efficacious and safe in transplant-eligible patients with newly diagnosed multiple myeloma. This study was registered at http://www.trialregister.nl as #NTR2422.

Original languageEnglish
Number of pages29
JournalHaematologica
Publication statusE-pub ahead of print - 4-Apr-2019

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