PMID- 37750384
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231103
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 19
DP  - 2023 Oct
TI  - Risk factors associated with overall survival in patients with multiple myeloma 
      following carfilzomib treatment: A retrospective study from a large claims 
      database in Japan.
PG  - 19361-19371
LID - 10.1002/cam4.6457 [doi]
AB  - 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.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Hagiwara, Hiromi
AU  - Hagiwara H
AUID- ORCID: 0000-0003-0855-0210
AD  - Department of Medical Innovation, Nagoya City University Graduate School of 
      Medical Sciences, Nagoya, Japan.
FAU - Nakayama, Takafumi
AU  - Nakayama T
AD  - Department of Cardiology, Nagoya City University Graduate School of Medical 
      Sciences, Nagoya, Japan.
FAU - Hashimoto, Hiroya
AU  - Hashimoto H
AUID- ORCID: 0000-0003-1865-4953
AD  - Department of Clinical Research Management Center, Nagoya City University 
      Hospital, Nagoya, Japan.
FAU - Kusumoto, Shigeru
AU  - Kusumoto S
AD  - Department of Hematology and Oncology, Nagoya City University Graduate School of 
      Medical Sciences, Nagoya, Japan.
FAU - Fukuta, Hidekatsu
AU  - Fukuta H
AD  - Department of Clinical Research Management Center, Nagoya City University 
      Hospital, Nagoya, Japan.
FAU - Kamiya, Takeshi
AU  - Kamiya T
AD  - Department of Clinical Research Management Center, Nagoya City University 
      Hospital, Nagoya, Japan.
FAU - Ikuta, Koichi
AU  - Ikuta K
AD  - Laboratory of Immune Regulation, Department of Virus Research, Institute for Life 
      and Medical Sciences, Kyoto University, Kyoto, Japan.
FAU - Iida, Shinsuke
AU  - Iida S
AD  - Department of Hematology and Oncology, Nagoya City University Graduate School of 
      Medical Sciences, Nagoya, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230926
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - F0P408N6V4 (Lenalidomide)
RN  - 72X6E3J5AR (carfilzomib)
RN  - 7S5I7G3JQL (Dexamethasone)
SB  - IM
MH  - Humans
MH  - *Multiple Myeloma/drug therapy/epidemiology
MH  - Lenalidomide
MH  - Japan/epidemiology
MH  - Retrospective Studies
MH  - Dexamethasone
MH  - Risk Factors
MH  - Antineoplastic Combined Chemotherapy Protocols/adverse effects
PMC - PMC10587963
OTO - NOTNLM
OT  - carfilzomib
OT  - large claims database
OT  - lenalidomide
OT  - multiple myeloma
OT  - overall survival
OT  - renal impairment
COIS- Shinsuke Iida has received honoraria from Sanofi, Janssen, Bristol-Myers Squibb, 
      Pfizer, Takeda, and Ono Pharmaceutical; and research grants from Chugai, Amgen, 
      AbbVie, GlaxoSmithKline, Daiichi Sankyo, Sanofi, Janssen, Bristol-Myers Squibb, 
      Pfizer, Takeda, and Ono Pharmaceutical; and is an editorial board member. Shigeru 
      Kusumoto has received research funding from Ono Pharmaceutical Co., Chugai, and 
      Daiichi Sankyo Ltd; and honoraria from Ono, Chugai, and Janssen. Takeshi Kamiya 
      has received honoraria from AstraZeneca K.K., EA Pharma Co., Ltd, Takeda 
      Pharmaceutical Company Limited, TOA Biopharma Co., Ltd, and MIYARISAN 
      Pharmaceutical Co., Ltd. Hiromi Hagiwara, Takafumi Nakayama, Hiroya Hashimoto, 
      Hidekatsu Fukuta and Koichi Ikuta have no conflicts of interest to declare.
EDAT- 2023/09/26 06:44
MHDA- 2023/10/23 01:18
PMCR- 2023/09/26
CRDT- 2023/09/26 05:43
PHST- 2023/07/13 00:00 [revised]
PHST- 2023/02/01 00:00 [received]
PHST- 2023/08/03 00:00 [accepted]
PHST- 2023/10/23 01:18 [medline]
PHST- 2023/09/26 06:44 [pubmed]
PHST- 2023/09/26 05:43 [entrez]
PHST- 2023/09/26 00:00 [pmc-release]
AID - CAM46457 [pii]
AID - 10.1002/cam4.6457 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Oct;12(19):19361-19371. doi: 10.1002/cam4.6457. Epub 2023 Sep 
      26.