Carfilzomib, dexamethasone, and daratumumab in Asian patients with relapsed or refractory multiple myeloma: post hoc subgroup analysis of the phase 3 CANDOR trial

• Published in: International journal of hematology Vol. 114; no. 6; pp. 653 - 663
• Main Authors: Suzuki, Kenshi, Min, Chang-Ki, Kim, Kihyun, Lee, Je-Jung, Shibayama, Hirohiko, Ko, Po-Shen, Huang, Shang-Yi, Li, Sin-Syue, Ding, Bifeng, Khurana, Monica, Iida, Shinsuke
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.12.2021; Springer Nature B.V
• Subjects: Adult; Adverse events; Aged; Aged, 80 and over; Antibodies, Monoclonal - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Asians; Demographics; Demography; Dexamethasone; Dexamethasone - administration & dosage; Drug Resistance, Neoplasm; Female; Hematology; Humans; Immunotherapy; Inhibitor drugs; Male; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Multiple myeloma; Multiple Myeloma - diagnosis; Multiple Myeloma - drug therapy; Multiple Myeloma - mortality; Oligopeptides - administration & dosage; Oncology; Original Article; Patients; Prognosis; Proportional Hazards Models; Recurrence; Retreatment; Risk assessment; Steroids; Subgroups; Targeted cancer therapy; Treatment Outcome; Carfilzomib; CANDOR trial; Relapsed refractory multiple myeloma; Asian population; Daratumumab
• ISSN: 0925-5710; 1865-3774
• DOI: 10.1007/s12185-021-03204-9

Background Due to increasing use of frontline lenalidomide, effective and safe lenalidomide-free therapies for relapsed/refractory multiple myeloma (RRMM) are needed in Asia. This subgroup analysis of phase 3 CANDOR study evaluated efficacy and safety of KdD vs Kd in Asian patients with RRMM. Methods Self-identified Asian patients with RRMM (KdD = 46; Kd = 20) with 1‒3 prior therapies were included. The primary endpoint of progression-free survival was estimated by stratified Cox regression. Results Baseline demographics and patient characteristics were balanced in both arms. KdD reduced the risk of progression or death by 25% vs Kd [hazard ratio (HR) = 0.75; 95% CI 0.259, 2.168] in the Asian subgroup, compared with 37% vs Kd (0.63; 0.464, 0.854) in the overall CANDOR population. Percentage of patients who reported grade ≥ 3 treatment-emergent adverse events (TEAEs) in the KdD and Kd arms was 95.7 and 90.0%, respectively. Serious AEs were observed in 58.7 and 40.0% of patients in the KdD and Kd arms, respectively. There were two (4.3%) fatal TEAEs in the KdD arm due to infections. Conclusions There was a trend toward better efficacy and a favorable benefit-risk profile for KdD vs Kd in Asian patients with RRMM. Cautious interpretation is warranted due to small patient size.