Carfilzomib plus pomalidomide and dexamethasone as salvage therapy in patients with relapsed or refractory multiple myeloma in China: a retrospective study.

Background: Regimens based on carfilzomib have shown significant improvement in survival for relapsed or refractory multiple myeloma (RRMM), but the combination of carfilzomib, pomalidomide and dexamethasone (KPd) has been scarcely investigated in China. This study aimed to evaluate the efficacy and safety of KPd regimen in Chinese patients with RRMM. Methods: Thirty-eight patients who had experienced one or more lines of therapy followed by the KPd regimen were retrospectively enrolled. After 4 cycles, the investigator switched eligible patients to maintenance therapy. The primary outcome was the objective response rate (ORR). The secondary endpoints included progression-free survival (PFS) and overall survival (OS). Adverse events (AEs) were also observed. Results: After 4 cycles of the KPd regimen, 23.7% of patients (9/38) achieved a complete response (CR), 42.1% (16/38) for very good partial response (VGPR), and 21.1% (8/38) for partial response (PR). The ORR was 86.8%. Of 33 patients who underwent maintenance therapy, 21 were administered the KPd regimen and 6 received daratumumab. The median PFS was 13.4 months and the median OS was not reached. Each patient experienced at least 2 AEs, mainly, neutropenia and anemia. Only 3 patients experienced Grade 3 AEs, and none of the other AEs was higher than Grade 2. No patient reported having experienced Grades 4-5 AEs. Conclusions: The KPd regimen showed encouraging activity and manageable toxicity for RRMM patients in China.