Drug updated on 4/15/2024
| Dosage Form | Injection (intravenous; 10 mg, 30 mg, 60 mg) |
| Drug Class | Proteasome inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with lenalidomide and dexamethasone.
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with dexamethasone.
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with daratumumab and dexamethasone.
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with daratumumab and hyaluronidase-fihj and dexamethasone.
- Indicated for use as a single agent for the treatment of patients with relapsed or refractory multiple myeloma who have received one or more lines of therapy.
- Indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with Isatuximab and dexamethasone.
Summary
- Carfilzomib (Kyprolis) is indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three lines of therapy in combination with various drugs such as lenalidomide, dexamethasone, daratumumab, and hyaluronidase-fihj. It can also be used as a single agent for those who have undergone one or more lines of therapy.
- The information was derived from 10 systematic reviews/meta-analyses that focused on comparing Kyprolis' safety and effectiveness against other drugs when treating multiple myeloma under different conditions.
- In terms of effectiveness, carfilzomib-based treatments showed superior objective response rates compared to other regimens like bortezomib with dexamethasone and lenalidomide with dexamethasone. For transplant-ineligible patients specifically, carfilzomib-based regimens had a higher overall response rate but did not show improvements in progression-free survival (PFS), overall survival (OS), and complete response rate.
- When considering safety aspects, it's important to note that carfilzomib has been associated with a higher risk of cardiovascular events compared to other proteasome inhibitors (PIs) and immunomodulatory drugs. There was also an increased risk observed for kidney toxicity especially at high grades when using carfilzomib-based regimens versus others.
- Subgroup considerations revealed significant attention given to how specific patient subgroups respond differently to this drug; these include groups having high-risk cytogenetic features (+1q), lenalidomide-sensitivity/refractoriness disease status, indicating a nuanced understanding required based on individual patient needs/conditions.
- Overall insights suggest that while Kyprolis demonstrates a potent efficacy profile particularly in combinations and challenging conditions like lenalidomide-refractory MM, its use is accompanied by higher risks of cardiovascular and renal adverse events compared to other treatments. Therefore, careful consideration of patient-specific risk factors and comorbidities is required.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Kyprolis (carfilzomib) Prescribing Information. | 2022 | Onyx Pharmaceuticals, Inc., Thousand Oaks, CA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Multiple myeloma, version 2.2024, NCCN clinical practice guidelines in oncology. | 2023 | Journal of the National Comprehensive Cancer Network |
| Clinical practice guideline multiple myeloma. | 2022 | Myeloma Australia |
| Multiple myeloma: EHA-ESMO clinical practice guidelines for diagnosis, treatment and follow-up. | 2021 | Annals of Oncology |
| Multiple myeloma, version 3.2021. | 2020 | Journal of the National Comprehensive Cancer Network |
| Management of patients with multiple myeloma in the era of COVID-19 pandemic: a consensus paper from the European myeloma network (EMN). | 2020 | Leukemia |
| Treatment of multiple myeloma: ASCO and CCO joint clinical practice guideline. | 2019 | Journal of Clinical Oncology |