Personalized Therapy for Multiple Myeloma by Saad Z. Usmani & Ajay K. Nooka

Author:Saad Z. Usmani & Ajay K. Nooka
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

5.9.1.2 Carfilzomib, Cyclophosphamide, and Dexamethasone (CCyD)

Carfilzomib has also been combined with cyclophosphamide and dexamethasone as a treatment regimen in a phase II study newly diagnosed patients who were not transplant eligible [86]. In this study, carfilzomib was given on a standard schedule on days 1, 2, 8, 9, 15, and 16 on a 28-day cycle at 20 mg/m2 on days 1 and 2 of cycle 1 and then 36 mg/m2 subsequently. Cyclophosphamide 300 mg/m2 orally was given on days 1, 8, and 15, and dexamethasone 40 mg was given orally on days 1, 8, 15, and 22. This study found a high response rate with an ORR of 95% and 20% stringent CR. In this older, transplant-ineligible patient population, the adverse event rate was comparable to other regimens, with grade ≥3 neutropenia (20%) and anemia (11%) and cardiopulmonary adverse events (7%). This regimen is currently being evaluated in patients after one prior line of treatment and compared to CyBorD in the Myeloma UK five study [87]. In this study, the dosing is similar to the regimen in newly diagnosed patients, though cyclophosphamide is given at 500 mg. Preliminary toxicity data has been presented so far, with grade ≥3 hematologic adverse events including anemia (19.4%), neutropenia (12%), and thrombocytopenia (10.5%) and non-hematologic ≥ grade 3 including infections (20.9%).

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.