Therapeutic advances in hematology · 2026
Real-world efficacy and safety of the carfilzomib-pomalidomide-dexamethasone regimen in patients with relapsed/refractory multiple myeloma: A multicenter retrospective study.
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Fan Huishou, Feng XiangYan, Wei Rongxia, Zhang Xin, Li Tianlan, Liu Lu, Wang Hui, Sun Lingjie, Shi Xue, Zhao Hongguo, Li Zhao, Cui Jingying, Xu Junqing, Ma Junjie, Feng Xianqi, Wang Wei
Аннотация
BACKGROUND: Relapsed and refractory multiple myeloma (RRMM) is generally associated with a poor prognosis.
OBJECTIVES: This real-world study aims to evaluate the efficacy and safety of the carfilzomib-pomalidomide-dexamethasone (KPd) regimen in patients with RRMM.
DESIGN: A multicenter, retrospective study was conducted in four centers in China.
METHODS: RRMM patients who received at least 1 cycle of KPd across four centers were retrospectively included and stratified by prior lines of treatment, survival outcomes and safety profile were analyzed.
RESULTS: A total of 82 patients were enrolled. Based on the lines of treatment (LOT) at KPd initiation, patients were stratified into second-line (2L, n=39), third-line (3L, n=26), and fourth-line or beyond (4L+, n=17) groups. Among 72 response-evaluable patients, the overall response rate (ORR) was 69.4%, with ORRs of 79.4%, 73.9%, and 40.0% in the 2L, 3L, and 4L+ groups, respectively. After a median follow-up of 10.8 months, the median progression-free survival (mPFS) for the entire cohort was 22.5 months, while the median overall survival (mOS) was not reached (NR). The mPFS was NR, 22.5, and 10.1 months (P=0.178), and the mOS was NR, NR, and 11.6 months (P=0.019) for patients receiving KPd in the 2L, 3L, and 4L+ settings, respectively. Multivariable analysis identified elevated lactate dehydrogenase (LDH) level (HR=3.489, 95% CI: 1.557-7.823) and LOT ≥4 (HR=2.791, 95% CI: 1.086-7.177) as independent predictors of inferior PFS (P<0.05), while LOT ≥4 (HR=3.917, 95% CI: 1.258-12.200) was also associated with worse OS (P=0.019). Grade ≥3 adverse events (AEs) occurred in 12.8%, 50.0%, and 47.1% of patients in the 2L, 3L, and 4L+ groups, respectively.
CONCLUSION: The KPd regimen demonstrated favorable clinical efficacy and manageable toxicity in RRMM, particularly in those with early-line relapse.
OBJECTIVES: This real-world study aims to evaluate the efficacy and safety of the carfilzomib-pomalidomide-dexamethasone (KPd) regimen in patients with RRMM.
DESIGN: A multicenter, retrospective study was conducted in four centers in China.
METHODS: RRMM patients who received at least 1 cycle of KPd across four centers were retrospectively included and stratified by prior lines of treatment, survival outcomes and safety profile were analyzed.
RESULTS: A total of 82 patients were enrolled. Based on the lines of treatment (LOT) at KPd initiation, patients were stratified into second-line (2L, n=39), third-line (3L, n=26), and fourth-line or beyond (4L+, n=17) groups. Among 72 response-evaluable patients, the overall response rate (ORR) was 69.4%, with ORRs of 79.4%, 73.9%, and 40.0% in the 2L, 3L, and 4L+ groups, respectively. After a median follow-up of 10.8 months, the median progression-free survival (mPFS) for the entire cohort was 22.5 months, while the median overall survival (mOS) was not reached (NR). The mPFS was NR, 22.5, and 10.1 months (P=0.178), and the mOS was NR, NR, and 11.6 months (P=0.019) for patients receiving KPd in the 2L, 3L, and 4L+ settings, respectively. Multivariable analysis identified elevated lactate dehydrogenase (LDH) level (HR=3.489, 95% CI: 1.557-7.823) and LOT ≥4 (HR=2.791, 95% CI: 1.086-7.177) as independent predictors of inferior PFS (P<0.05), while LOT ≥4 (HR=3.917, 95% CI: 1.258-12.200) was also associated with worse OS (P=0.019). Grade ≥3 adverse events (AEs) occurred in 12.8%, 50.0%, and 47.1% of patients in the 2L, 3L, and 4L+ groups, respectively.
CONCLUSION: The KPd regimen demonstrated favorable clinical efficacy and manageable toxicity in RRMM, particularly in those with early-line relapse.