Overview
Carfilzomib is a commonly used treatment for patients with relapsed or refractory multiple myeloma (RRMM). Despite its widespread use over the past decade, there is still no consensus on the most effective carfilzomib dosing schedule to achieve durable responses while minimizing toxicity and unnecessary clinic visits.
This study used the Flatiron Health EHR-derived database to evaluate three modern carfilzomib dosing patterns: 56 mg/m² once weekly (K56-1x), 56 mg/m² twice weekly (K56-2x), and 70 mg/m² once weekly (K70-1x). Among 486 patients treated with modern dosing patterns between 2016 and 2023, once-weekly dosing became increasingly common over time. By 2023, over half of patients received K70-1x, and more than a third received K56-1x, while use of the twice-weekly K56-2x regimen declined significantly. Median progression-free survival was similar across all three groups, and heart failure rates were comparable (<5%).
Why this matters
This research provides important real-world evidence to help guide treatment decisions for patients with RRMM. Despite historical use of twice-weekly dosing, the study found no significant benefit in outcomes compared to once-weekly regimens. This research offers critical insight into the best balance of effectiveness, safety, and reduced treatment burden—minimizing the need for frequent clinic visits without compromising patient outcomes. These findings can help inform more patient-centered care and support evolving clinical practice toward more convenient dosing strategies.