Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease
Published experience with carfilzomib in patients with relapsed/refractory multiple myeloma (RRMM) and extramedullary disease (EMD) is still limited. The current study aimed to assess the efficacy and safety of carfilzomib containing therapy regimens in EMD. We retrospectively analyzed 45 patients w...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-04-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/4/1035 |
| _version_ | 1797569863537917952 |
|---|---|
| author | Xiang Zhou Patricia Flüchter Katharina Nickel Katharina Meckel Janin Messerschmidt David Böckle Sebastian Knorz Maximilian Johannes Steinhardt Franziska Krummenast Sophia Danhof Hermann Einsele K. Martin Kortüm Leo Rasche |
| author_facet | Xiang Zhou Patricia Flüchter Katharina Nickel Katharina Meckel Janin Messerschmidt David Böckle Sebastian Knorz Maximilian Johannes Steinhardt Franziska Krummenast Sophia Danhof Hermann Einsele K. Martin Kortüm Leo Rasche |
| author_sort | Xiang Zhou |
| collection | DOAJ |
| description | Published experience with carfilzomib in patients with relapsed/refractory multiple myeloma (RRMM) and extramedullary disease (EMD) is still limited. The current study aimed to assess the efficacy and safety of carfilzomib containing therapy regimens in EMD. We retrospectively analyzed 45 patients with extramedullary RRMM treated with carfilzomib from June 2013 to September 2019. The median age at the start of carfilzomib was 64 (range 40–80) years. Twenty (44%) and 25 (56%) patients had paraosseous manifestation and EMD without adjacency to bone, respectively. The serological overall response rate (ORR) was 59%. Extramedullary response was evaluable in 33 patients, nine (27%) of them achieved partial remission (PR) (ORR = 27%). In 15 (33%) patients, we observed no extramedullary response despite serological response. The median progression-free survival (PFS) and overall survival (OS) were five (95% CI, 3.5–6.5) and ten (95% CI, 7.5–12.5) months, respectively. EMD without adjacency to bone was associated with a significantly inferior PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.04) compared to paraosseous lesions. Carfilzomib based treatment strategies showed some efficacy in heavily pretreated patients with extramedullary RRMM but could not overcome the negative prognostic value of EMD. Due to the discrepancy between serological and extramedullary response, evaluation of extramedullary response using imaging is mandatory in these patients. |
| first_indexed | 2024-03-10T20:17:27Z |
| format | Article |
| id | doaj.art-890d04cdafc24636926f7cf0d0fa57f6 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T20:17:27Z |
| publishDate | 2020-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-890d04cdafc24636926f7cf0d0fa57f62023-11-19T22:28:11ZengMDPI AGCancers2072-66942020-04-01124103510.3390/cancers12041035Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary DiseaseXiang Zhou0Patricia Flüchter1Katharina Nickel2Katharina Meckel3Janin Messerschmidt4David Böckle5Sebastian Knorz6Maximilian Johannes Steinhardt7Franziska Krummenast8Sophia Danhof9Hermann Einsele10K. Martin Kortüm11Leo Rasche12Department of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyDepartment of Internal Medicine II, University Hospital of Würzburg, D-97080 Würzburg, GermanyPublished experience with carfilzomib in patients with relapsed/refractory multiple myeloma (RRMM) and extramedullary disease (EMD) is still limited. The current study aimed to assess the efficacy and safety of carfilzomib containing therapy regimens in EMD. We retrospectively analyzed 45 patients with extramedullary RRMM treated with carfilzomib from June 2013 to September 2019. The median age at the start of carfilzomib was 64 (range 40–80) years. Twenty (44%) and 25 (56%) patients had paraosseous manifestation and EMD without adjacency to bone, respectively. The serological overall response rate (ORR) was 59%. Extramedullary response was evaluable in 33 patients, nine (27%) of them achieved partial remission (PR) (ORR = 27%). In 15 (33%) patients, we observed no extramedullary response despite serological response. The median progression-free survival (PFS) and overall survival (OS) were five (95% CI, 3.5–6.5) and ten (95% CI, 7.5–12.5) months, respectively. EMD without adjacency to bone was associated with a significantly inferior PFS (<i>p</i> = 0.004) and OS (<i>p</i> = 0.04) compared to paraosseous lesions. Carfilzomib based treatment strategies showed some efficacy in heavily pretreated patients with extramedullary RRMM but could not overcome the negative prognostic value of EMD. Due to the discrepancy between serological and extramedullary response, evaluation of extramedullary response using imaging is mandatory in these patients.https://www.mdpi.com/2072-6694/12/4/1035carfilzomibextramedullary diseasemultiple myelomarelapserefractory |
| spellingShingle | Xiang Zhou Patricia Flüchter Katharina Nickel Katharina Meckel Janin Messerschmidt David Böckle Sebastian Knorz Maximilian Johannes Steinhardt Franziska Krummenast Sophia Danhof Hermann Einsele K. Martin Kortüm Leo Rasche Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease Cancers carfilzomib extramedullary disease multiple myeloma relapse refractory |
| title | Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease |
| title_full | Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease |
| title_fullStr | Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease |
| title_full_unstemmed | Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease |
| title_short | Carfilzomib Based Treatment Strategies in the Management of Relapsed/Refractory Multiple Myeloma with Extramedullary Disease |
| title_sort | carfilzomib based treatment strategies in the management of relapsed refractory multiple myeloma with extramedullary disease |
| topic | carfilzomib extramedullary disease multiple myeloma relapse refractory |
| url | https://www.mdpi.com/2072-6694/12/4/1035 |
| work_keys_str_mv | AT xiangzhou carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT patriciafluchter carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT katharinanickel carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT katharinameckel carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT janinmesserschmidt carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT davidbockle carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT sebastianknorz carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT maximilianjohannessteinhardt carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT franziskakrummenast carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT sophiadanhof carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT hermanneinsele carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT kmartinkortum carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease AT leorasche carfilzomibbasedtreatmentstrategiesinthemanagementofrelapsedrefractorymultiplemyelomawithextramedullarydisease |