Dr C. Ola Landgren Highlights Use of Carfilzomib in Newly Diagnosed Patients With MM

New research shows that carfilzomib in newly diagnosed patients with multiple myeloma resulted in a higher rate of minimal residual disease negativity compared with usual rates, said C. Ola Landgren, MD, PhD, professor of medicine and chief of the Myeloma Service at Memorial Sloan Kettering Cancer.

Transcript

Carfilzomib is currently approved to treat patients with relapsed or refractory multiple myeloma—what did you find regarding the safety and efficacy of carfilzomib in newly diagnosed patients?

At [the 61st American Society of Hematology (ASH) Annual Meeting and Exposition] 2019, I’m the lead presenter, I’m the lead principal investigator for a phase 2 trial developed at [Memorial] Sloan Kettering where we used the combination of carfilzomib with lenalidomide, dexamethasone, and also daratumumab. And this is a phase 2 trial targeting newly diagnosed multiple myeloma patients.

The cohort I present uses once a week dosing with carfilzomib—it’s a so-called 20/56 mg per meter squared dosing. So, 20 mg per meter squared, the first dose, and every other dose after that 56 mg per meter squared. So, once a week on a 4-week schedule means day 1, day 8, and day 15. Daratumumab is given standard dosing per the FDA label, which is 16 mg/kg body weight and is given weekly for the first 2 cycles and then is a every other week for another 4 cycles. And the last cycles are once every 4 weeks. This phase 2 trial includes a total of 8 cycles of therapy.

And the patient can go on [the trial], if they have a new diagnosis of myeloma, they fit the standard eligibility criteria, and it doesn’t matter if they are younger or older, it doesn’t matter if they are transplant candidates or not. Because the study is designed to look at minimal residual disease (MRD) as the primary end point after 8 cycles.

In the current literature, the best published MRD rates are in the range of around 30% or 40% or so—in this study that’s not yet published, but presented at the ASH 2019, we report MRD rate of around 80%, and this is without bone marrow transplantation.