Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan
Abstract Background Carfilzomib is a selective proteasome inhibitor approved for treating relapsed or refractory multiple myeloma (RRMM). Carfilzomib improves overall survival (OS) and progression‐free survival (PFS); however, treatment with carfilzomib results in a higher incidence of cardiovascula...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-10-01
|
| Series: | Cancer Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/cam4.6457 |
| _version_ | 1797654475925618688 |
|---|---|
| author | Hiromi Hagiwara Takafumi Nakayama Hiroya Hashimoto Shigeru Kusumoto Hidekatsu Fukuta Takeshi Kamiya Koichi Ikuta Shinsuke Iida |
| author_facet | Hiromi Hagiwara Takafumi Nakayama Hiroya Hashimoto Shigeru Kusumoto Hidekatsu Fukuta Takeshi Kamiya Koichi Ikuta Shinsuke Iida |
| author_sort | Hiromi Hagiwara |
| collection | DOAJ |
| description | Abstract Background Carfilzomib is a selective proteasome inhibitor approved for treating relapsed or refractory multiple myeloma (RRMM). Carfilzomib improves overall survival (OS) and progression‐free survival (PFS); however, treatment with carfilzomib results in a higher incidence of cardiovascular and renal toxicity. More than 70% of patients with RRMM in clinical practice do not meet the eligibility criteria for randomized clinical trials (RCT). OS and PFS are negatively influenced by complications, concomitant medications and prior treatments. Therefore, we assessed the risk factors influencing the OS and time to next treatment (TTNT) in the real world. TTNT has emerged as a relevant alternative clinical endpoint to PFS. Methods A retrospective analysis of a large claims database prepared during the post‐marketing stages in Japan was performed. The patients treated with carfilzomib for the first time were identified. Multivariable Cox proportional hazards regression analysis was performed to evaluate the risk factors influencing OS and TTNT following carfilzomib treatment. Results A total of 732 patients with RRMM who received carfilzomib‐containing chemotherapy between April 2014 and September 2021 were identified. Multivariable Cox regression analysis for OS and TTNT showed a significantly higher hazard ratio (HR) of 1.48 (95% confidence interval [Cl]: 1.10–2.00; p = 0.010) and 1.38 (95% Cl: 1.15–1.65; p < 0.001), respectively, for patients with renal impairment compared to those without renal impairment. Multivariable Cox regression analysis for OS and TTNT showed a significantly higher HR of 1.80 (95% Cl: 1.27–2.55; p = 0.0010) and 1.38 (95% Cl: 1.14–1.66; p < 0.001), respectively, for patients with prior lenalidomide treatment compared to those without prior lenalidomide treatment. Conclusion Complication of renal impairment and prior lenalidomide treatment could be risk factors influencing OS and TTNT during carfilzomib treatment. |
| first_indexed | 2024-03-11T17:00:01Z |
| format | Article |
| id | doaj.art-18211c8cd7604a2a88d7ac7380485fd7 |
| institution | Directory Open Access Journal |
| issn | 2045-7634 |
| language | English |
| last_indexed | 2024-03-11T17:00:01Z |
| publishDate | 2023-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Medicine |
| spelling | doaj.art-18211c8cd7604a2a88d7ac7380485fd72023-10-20T10:25:44ZengWileyCancer Medicine2045-76342023-10-011219193611937110.1002/cam4.6457Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in JapanHiromi Hagiwara0Takafumi Nakayama1Hiroya Hashimoto2Shigeru Kusumoto3Hidekatsu Fukuta4Takeshi Kamiya5Koichi Ikuta6Shinsuke Iida7Department of Medical Innovation Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Cardiology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Clinical Research Management Center Nagoya City University Hospital Nagoya JapanDepartment of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya JapanDepartment of Clinical Research Management Center Nagoya City University Hospital Nagoya JapanDepartment of Clinical Research Management Center Nagoya City University Hospital Nagoya JapanLaboratory of Immune Regulation, Department of Virus Research, Institute for Life and Medical Sciences Kyoto University Kyoto JapanDepartment of Hematology and Oncology Nagoya City University Graduate School of Medical Sciences Nagoya JapanAbstract Background Carfilzomib is a selective proteasome inhibitor approved for treating relapsed or refractory multiple myeloma (RRMM). Carfilzomib improves overall survival (OS) and progression‐free survival (PFS); however, treatment with carfilzomib results in a higher incidence of cardiovascular and renal toxicity. More than 70% of patients with RRMM in clinical practice do not meet the eligibility criteria for randomized clinical trials (RCT). OS and PFS are negatively influenced by complications, concomitant medications and prior treatments. Therefore, we assessed the risk factors influencing the OS and time to next treatment (TTNT) in the real world. TTNT has emerged as a relevant alternative clinical endpoint to PFS. Methods A retrospective analysis of a large claims database prepared during the post‐marketing stages in Japan was performed. The patients treated with carfilzomib for the first time were identified. Multivariable Cox proportional hazards regression analysis was performed to evaluate the risk factors influencing OS and TTNT following carfilzomib treatment. Results A total of 732 patients with RRMM who received carfilzomib‐containing chemotherapy between April 2014 and September 2021 were identified. Multivariable Cox regression analysis for OS and TTNT showed a significantly higher hazard ratio (HR) of 1.48 (95% confidence interval [Cl]: 1.10–2.00; p = 0.010) and 1.38 (95% Cl: 1.15–1.65; p < 0.001), respectively, for patients with renal impairment compared to those without renal impairment. Multivariable Cox regression analysis for OS and TTNT showed a significantly higher HR of 1.80 (95% Cl: 1.27–2.55; p = 0.0010) and 1.38 (95% Cl: 1.14–1.66; p < 0.001), respectively, for patients with prior lenalidomide treatment compared to those without prior lenalidomide treatment. Conclusion Complication of renal impairment and prior lenalidomide treatment could be risk factors influencing OS and TTNT during carfilzomib treatment.https://doi.org/10.1002/cam4.6457carfilzomiblarge claims databaselenalidomidemultiple myelomaoverall survivalrenal impairment |
| spellingShingle | Hiromi Hagiwara Takafumi Nakayama Hiroya Hashimoto Shigeru Kusumoto Hidekatsu Fukuta Takeshi Kamiya Koichi Ikuta Shinsuke Iida Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan Cancer Medicine carfilzomib large claims database lenalidomide multiple myeloma overall survival renal impairment |
| title | Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan |
| title_full | Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan |
| title_fullStr | Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan |
| title_full_unstemmed | Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan |
| title_short | Risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment: A retrospective study from a large claims database in Japan |
| title_sort | risk factors associated with overall survival in patients with multiple myeloma following carfilzomib treatment a retrospective study from a large claims database in japan |
| topic | carfilzomib large claims database lenalidomide multiple myeloma overall survival renal impairment |
| url | https://doi.org/10.1002/cam4.6457 |
| work_keys_str_mv | AT hiromihagiwara riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT takafuminakayama riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT hiroyahashimoto riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT shigerukusumoto riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT hidekatsufukuta riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT takeshikamiya riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT koichiikuta riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan AT shinsukeiida riskfactorsassociatedwithoverallsurvivalinpatientswithmultiplemyelomafollowingcarfilzomibtreatmentaretrospectivestudyfromalargeclaimsdatabaseinjapan |