Comparative efficacy of carfilzomib, lenalidomide, and dexamethasone ( KRd ) versus bortezomib, lenalidomide, and dexamethasone ( VRd ) in newly‐diagnosed multiple myeloma: A systematic review and meta‐analysis

• Published in: American journal of hematology Vol. 99; no. 7; pp. 1411 - 1414
• Main Authors: Costa, Bruno Almeida, Costa, Thomaz Alexandre, Pak, Kevin, Patel, Aesha, Felix, Nicole, Mouhieddine, Tarek H., Richter, Joshua
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.07.2024
• Subjects: Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bortezomib; Bortezomib - administration & dosage; Bortezomib - therapeutic use; Cytogenetics; Dexamethasone; Dexamethasone - administration & dosage; Dexamethasone - therapeutic use; Humans; Immunotherapy; Inhibitor drugs; Lenalidomide - administration & dosage; Lenalidomide - therapeutic use; Meta-analysis; Multiple myeloma; Multiple Myeloma - drug therapy; Multiple Myeloma - mortality; Oligopeptides - administration & dosage; Oligopeptides - therapeutic use; Progression-Free Survival; Survival; Targeted cancer therapy; Treatment Outcome
• ISSN: 0361-8609; 1096-8652; 1096-8652
• DOI: 10.1002/ajh.27314

In view of the increasing data evaluating carfilzomib-based induction for newly-diagnosed multiple myeloma (NDMM), we conducted a systematic review and meta-analysis comparing the efficacy of carfilzomib/lenalidomide/dexamethasone (KRd) versus bortezomib/lenalidomide/dexamethasone (VRd). Three studies totaling 1597 patients (50% KRd-treated, 50% VRd-treated) were included. Despite similar survival outcomes and overall response rate compared with the VRd arm, KRd-treated subjects showed higher odds of achieving complete responses and measurable residual disease negativity. Among patients with high-risk cytogenetics (n = 348), KRd was associated with significant improvement in progression-free survival (HR = 0.70; 95% CI = 0.50-0.97; p = .03; I  = 0%), suggesting carfilzomib-based induction may be preferable in this NDMM subpopulation.