Carfilzomib

(Kyprolis®)

Carfilzomib

Drug updated on 4/15/2024

Dosage FormInjection (intravenous; 10 mg, 30 mg, 60 mg)
Drug ClassProteasome 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.

Latest News

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Summary
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  • 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 TitleYearSource
Kyprolis (carfilzomib) Prescribing Information.2022Onyx Pharmaceuticals, Inc., Thousand Oaks, CA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
Alterations in chromosome 1q in multiple myeloma randomized clinical trials: a systematic review.2024Blood Cancer Journal
Comparative efficacy of novel-drugs combined therapeutic regimens on relapsed/refractory multiple myeloma: a network meta-analysis. 2023Hematology
Lenalidomide-based triplet regimens in first relapsed multiple myeloma patients: real-world evidence from a propensity score matched analysis. 2023Hematologica
Cardiotoxicity as an adverse effect of immunomodulatory drugs and proteasome inhibitors in multiple myeloma: a network meta‚Äźanalysis of randomized clinical trials.2022Hematological Oncology
Efficacy and safety of selinexor-based regimens for relapsed/refractory multiple myeloma: a systematic review of literature.2022Annals of Hematology
Efficacy of maintenance treatment in patients with multiple myeloma: a systematic review and network meta-analysis. 2022Hematology
Efficacy and toxicity of carfilzomib- or bortezomib-based regimens for treatment of transplant-ineligible patients with newly diagnosed multiple myeloma: A meta-analysis. 2022Medicine
A systematic review and network meta-analysis of randomized data on efficacy of novel therapy combinations in patients with lenalidomide-refractory multiple myeloma.2021Clinical Lymphoma, Myeloma and Leukemia
Risk of kidney toxicity with carfilzomib in multiple myeloma: a meta-analysis of randomized controlled trials.2020Annals of Hematology
Efficacy and safety of carfilzomib-based regimens in frail patients with relapsed and/or refractory multiple myeloma. 2020Blood

Clinical Practice Guidelines