Fecha de recepción: 22/01/2018 – Fecha de aceptación: 25/04/2018
Pascual-Marmaneu O1, Montañés-Pauls B1, Bellés-Medall MD1, Álvarez-Arroyo L2, Serrano Picazo L3, Ferrando-Piqueres R1
1 Servicio de Farmacia Hospitalaria. Hospital General Universitario de Castellón. Castellón (España)
2 Servicio de Farmacia Hospitalaria. Hospital Universitario de la Plana. Villarreal (España)
3 Servicio de Hematología. Hospital General Universitario de Castellón. Castellón (España)
Óscar Pascual Marmaneu
Avda. Hermanos Bou, 13 6º A
Correo electrónico: firstname.lastname@example.org
Objective: To analyze the efficacy and safety of carfilzomib in the treatment of relapsed and/or refractory multiple myeloma (RRMM) and to evaluate the results based on the therapeutic scheme and dose of carfilzomib used.
Methods: Retrospective analysis that included patients on treatment with carfilzomib from December 2015 to August 2017. Demographic, disease, analytical, response and toxicity variables were analyzed.
Results: We included 13 patients (85% males), 67 years old (interquartile range (IQR: 57-70), with a disease evolution time of 33 months (IQR: 12-53) and stage 3 in 69% of the subjects. The overall response rate was 46%, the response time was 1.5 months (IQR: 1-3) and the duration of the response was 6.5 months (IQR: 4.8-11.5). The median progression-free survival was 3.2 months (95% CI: 2.1-not reached) and overall survival was 8.1 months (95% CI: 2.5-not reached). No significant differences were observed in the risk of progression or mortality according to the scheme and dose of carfilzomib used. Thrombocytopenia and anemia were the most frequent adverse effects, appearing in 38.5% and 30.8% of patients.
Conclusions: The efficacy of carfilzomib was low in this series, where carfilzomib was used in patients of high complexity in advanced treatment lines. In this sense, the criteria for the use of this drug in clinical practice differ from those described in clinical trials. Therefore, larger studies are needed to position carfilzomib in the treatment of RRMM in clinical practice.
Key Words: Carfilzomib, multiple myeloma, relapse, drug resistance, proteasome inhibitor, survival analyses.