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Preliminary results from an ongoing Phase 1 clinical trial indicate that carfilzomib, a new proteasome inhibitor, has significant therapeutic results in patients with relapsed myeloma. The Multiple Myeloma Research Consortium (MMRC) reported the results at the Joint ECCO 15-34th ESMO Multidisciplinary Congress, which was held in Berlin from September 20 to 24.
Carfilzomib selectively induces cell death in cancer cells by blocking the activity of proteasomes, which are enzymes that break down proteins. Carfilzomib is similar to Velcade (bortezomib), the first proteasome inhibitor approved for multiple myeloma treatment. However, carfilzomib reduces peripheral neuropathy, the pain and numbness in patients’ hands and feet, as compared to Velcade. Carfilzomib is also a more selective therapeutic agent – it results in fewer or less severe side effects than Velcade.
The current Phase 1 trial presented at the Berlin conference enrolled 31 multiple myeloma patients. Seventeen of the participants had previously received Velcade, of which 15 had relapsed after an autologous stem cell transplant. All 31 patients received a dose of 20 mg/m2 carfilzomib on days 1, 2, 8, 9, 15, and 16 in a 28-day cycle for up to 12 cycles, and 4 mg of dexamethasone (Decadron) was administered prior to each carfilzomib dosage in the first cycle.
At the time of the September conference, the 31 patients had received an average of 6.6 treatment cycles, with 11 patients receiving all 12 cycles without any evidence of disease progression. The most common side effects observed in patients were fatigue (61 percent), nausea (58 percent), and vomiting (36 percent).
Researchers noted that more than 30 percent of patients who responded to carfilzomib tolerated full-dose therapy without disease progression for at least one year. These initial data suggest that carfilzomib may potentially be used in multiple myeloma treatments as an alternative to the current proteasome inhibitor, Velcade. Future clinical trials may evaluate a head-to-head comparison of carfilzomib and Velcade to determine which treatment is more effective for multiple myeloma patients.
For more information, please read a press release on the Phase 1 trial results. or see abstract 9201 from the ECCO-ESMO Conference.
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