TY  - JOUR
A1  - Zhou, Xiang
A1  - Flüchter, Patricia
A1  - Nickel, Katharina
A1  - Meckel, Katharina
A1  - Messerschmidt, Janin
A1  - Böckle, David
A1  - Knorz, Sebastian
A1  - Steinhardt, Maximilian Johannes
A1  - Krummenast, Franziska
A1  - Danhof, Sophia
A1  - Einsele, Hermann
A1  - Kortüm, K. Martin
A1  - Rasche, Leo
T1  - Carfilzomib based treatment strategies in the management of relapsed/refractory multiple myeloma with extramedullary disease
T2  - Cancers
N2  - 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 (p = 0.004) and OS (p = 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.
KW  - carfilzomib
KW  - extramedullary disease
KW  - multiple myeloma
KW  - relapse
KW  - refractory
Y1  - 2020
UR  - https://opus.bibliothek.uni-wuerzburg.de/frontdoor/index/index/docId/20370
UR  - https://nbn-resolving.org/urn:nbn:de:bvb:20-opus-203704
SN  - 2072-6694
VL  - 12
IS  - 4
ER  -