PMID- 30719266
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220331
IS  - 2040-6207 (Print)
IS  - 2040-6215 (Electronic)
IS  - 2040-6207 (Linking)
VI  - 10
DP  - 2019
TI  - A real-world comparative analysis of carfilzomib and other systemic multiple 
      myeloma chemotherapies in a US community oncology setting.
PG  - 2040620718816699
LID - 10.1177/2040620718816699 [doi]
LID - 2040620718816699
AB  - BACKGROUND: Most multiple myeloma (MM) patients ultimately progress, with 
      remission duration decreasing after first relapse. Recently, novel agents have 
      been approved for the treatment of relapsed MM. There is a paucity of real-world 
      data on these treatments. We sought to compare time to next treatment (TTNT) in 
      MM patients in their second line of therapy (LOT2), treated with common 
      proteasome inhibitor (PI)-based triplets. METHODS: Adult MM patients who received 
      carfilzomib (K) between 1 November 2013 and 29 February 2016 at US Oncology 
      Network (USON) clinics utilizing iKnowMed electronic health records (EHRs) were 
      identified. Patients were included if they were ⩾18 years of age, not enrolled in 
      clinical trials, had ⩾2 visits at a USON clinic and received LOT2 regimens 
      consisting of: K+lenalidomide with steroid (KRd), bortezomib+lenalidomide with 
      steroid (VRd), or bortezomib+cyclophosphamide with steroid (VCyd). TTNT was 
      estimated from LOT2 initiation to LOT3 initiation using the Kaplan-Meier method, 
      and hazard ratios (HRs) were estimated using Cox modeling. RESULTS: A total of 
      718 patients received a K-containing regimen sometime during their MM treatment 
      (LOT1 to LOT5). Of these, 156 patients received: KRd (n = 112; 71.8%), VRd (n 
      =27; 17.3%), or VCyd (n = 17; 10.9%). Baseline characteristics were similar 
      between groups (mean age: 64.8 years; 58% male). Median TTNT was longest for KRd 
      [25.3 months; 95% confidence interval (CI): 19.71-NR], versus VRd or VCyd (VRd 
      median TTNT: 10.2 months, 95% CI: 4.24-12.71; VCyd: 6.5 months, 95% CI: 
      3.02-12.78; log-rank p < 0.0001). The adjusted HR for KRd was 0.19 (95% CI: 
      0.11-0.37), compared with VRd. CONCLUSIONS: Considering the real-world nature of 
      these data, the median TTNT observed with KRd was relatively consistent, with 
      progression-free survival (PFS) for KRd observed in the phase III ASPIRE trial 
      (median PFS: ITT population = 26.3 months; LOT2 = 29.6 months). Patients who 
      received KRd at first relapse had significantly longer TTNT, compared with those 
      on VRd or VCyd, confirming the value of KRd as an important treatment option for 
      relapsed MM.
FAU - Rifkin, Robert M
AU  - Rifkin RM
AD  - Rocky Mountain Cancer Centers, Denver, CO, USA McKesson Specialty Health, The US 
      Oncology Network, The Woodlands, TX, USA.
FAU - Medhekar, Rohan
AU  - Medhekar R
AD  - Amgen, Inc., Thousand Oaks, CA, USA.
FAU - Amirian, E Susan
AU  - Amirian ES
AD  - McKesson Specialty Health, The US Oncology Network, The Woodlands, TX, USA.
FAU - Aguilar, Kathleen M
AU  - Aguilar KM
AUID- ORCID: 0000-0002-2467-8663
AD  - McKesson Specialty Health, The US Oncology Network, The Woodlands, TX, USA.
FAU - Wilson, Thomas
AU  - Wilson T
AD  - McKesson Specialty Health, The US Oncology Network, The Woodlands, TX, USA.
FAU - Boyd, Marley
AU  - Boyd M
AD  - McKesson Specialty Health, The US Oncology Network, The Woodlands, TX, USA.
FAU - Mezzi, Khalid
AU  - Mezzi K
AD  - Amgen, Inc., Thousand Oaks, CA, USA.
FAU - Panjabi, Sumeet
AU  - Panjabi S
AD  - Amgen, Inc., 1120 Veterans Blvd, South San Francisco, CA 91320, USA.
LA  - eng
PT  - Journal Article
DEP - 20190111
PL  - England
TA  - Ther Adv Hematol
JT  - Therapeutic advances in hematology
JID - 101549589
PMC - PMC6348507
OTO - NOTNLM
OT  - carfilzomib
OT  - comparative effectiveness
OT  - multiple myeloma
OT  - relapse
OT  - second-line of therapy
COIS- Conflict of interest statement: The authors declare that there is no conflict of 
      interest.
EDAT- 2019/02/06 06:00
MHDA- 2019/02/06 06:01
PMCR- 2019/01/11
CRDT- 2019/02/06 06:00
PHST- 2018/07/13 00:00 [received]
PHST- 2018/11/01 00:00 [accepted]
PHST- 2019/02/06 06:00 [entrez]
PHST- 2019/02/06 06:00 [pubmed]
PHST- 2019/02/06 06:01 [medline]
PHST- 2019/01/11 00:00 [pmc-release]
AID - 10.1177_2040620718816699 [pii]
AID - 10.1177/2040620718816699 [doi]
PST - epublish
SO  - Ther Adv Hematol. 2019 Jan 11;10:2040620718816699. doi: 10.1177/2040620718816699. 
      eCollection 2019.