Carfilzomib in relapsed/refractory multiple myeloma patients - real world evidence - experiences of the Croatian cooperative group for hematologic diseases (KROHEM).

Background: Carfilzomib-based regimens brought a significant improvement in the treatment of relapsed/refractory multiple myeloma (RRMM). Even though efficacy and safety profiles of carfilzomib are well-established in several clinical trials, there is limited real-world data with carfilzomib-based protocols. Here we present our real-world experience with carfilzomib-based regimens for treatment of patients with RRMM in Croatia.

Methods: Data on patients with RRMM starting carfilzomib-based protocols in the period between June 2019 and February 2023 was collected by retrospective chart review from 14 Croatian centres.

Results: A total of 119 patients with RRMM were included; median age was 66 years (range 45-83 years), 59 (49.6 %) were females, and the median number of previous lines of therapies was 2 (range 1-8). Triplet based regimen was treatment choice in 84 (70.6 %) and 35 (29.4 %) patients were treated with carfilzomib in combination with dexamethasone (Kd). Overall response rate was 61.7 %, with 20 patients (18.7 %) achieving complete response (CR). Median progression free survival (PFS) and overall survival (OS) for entire cohort were 9.4 and 13.2 months, respectively. Median PFS was 12.8 months and 4.1 months for the triplets and doublets, respectively; the corresponding median OS was 18.6 and 7.9 months, respectively. The most common adverse events were anemia and thrombocytopenia; 19 patients (16 %) experienced cardiovascular events.

Conclusion: This is the first study to analyze clinical outcomes of RRMM patients treated with carfilzomib-based regimens in Croatia. Carfilzomib-based regimens showed substantial efficacy and acceptable toxicity in RRMM, especially in earlier treatment lines and triplet combinations.