A practical review on carfilzomib in multiple myeloma

Eur J Haematol. 2016 Jun;96(6):564-77. doi: 10.1111/ejh.12749. Epub 2016 Mar 9.

Abstract

Carfilzomib, a second-generation proteasome inhibitor, has been increasingly used in relapsed/refractory multiple myeloma (MM) since its approval by the American food and drug administration (FDA) in the summer of 2012. The drug is active as a single agent and in combination with other antimyeloma agents. As a result of its efficacy and safety in the relapsed/refractory setting, carfilzomib is being evaluated in patients with newly diagnosed MM as well as in high-risk smoldering MM. This review will give a comprehensive summary of the drug, including its mechanism of action, the evaluated doses and schedules as well as a summary of the main clinical trials in the relapsed/refractory and newly diagnosed settings. A focus will be placed upon certain subgroups of interest as well as a description of the toxicity associated with carfilzomib use and a clinical perspective on toxicity management.

Keywords: carfilzomib; combination regimen; induction; multiple myeloma; proteasome inhibitors; relapse.

Publication types

  • Review

MeSH terms

  • Animals
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / pharmacokinetics
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Clinical Trials, Phase I as Topic
  • Clinical Trials, Phase II as Topic
  • Clinical Trials, Phase III as Topic
  • Comorbidity
  • Drug Evaluation, Preclinical
  • Drug Resistance, Neoplasm
  • Humans
  • Multiple Myeloma / complications
  • Multiple Myeloma / drug therapy*
  • Multiple Myeloma / pathology
  • Oligopeptides / administration & dosage
  • Oligopeptides / adverse effects
  • Oligopeptides / pharmacokinetics
  • Oligopeptides / therapeutic use*
  • Proteasome Inhibitors / administration & dosage
  • Proteasome Inhibitors / adverse effects
  • Proteasome Inhibitors / pharmacokinetics
  • Proteasome Inhibitors / therapeutic use*
  • Recurrence
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Oligopeptides
  • Proteasome Inhibitors
  • carfilzomib