An overview of the role of carfilzomib in the treatment of multiple myeloma

ABSTRACT

Introduction: Carfilzomib is a second-generation proteasome inhibitor that binds selectively and irreversibly with the chymotrypsin-like site of the proteolytic core. Its initial approval by the Food and Drug Administration, as monotherapy for relapsed/refractory multiple myeloma (RR-MM), followed soon by a global authorization of its combination with dexamethasone or with lenalidomide plus dexamethasone for the treatment of RR-MM after 1–3 prior lines. In order to optimize its administration, carfilzomib is currently examined in different doses and regimens in relapsed/refractory as well as in newly diagnosed myeloma.

Areas covered: This review will focus on the introduction of carfilzomib as an effective anti-myeloma treatment, describing the evolution of the drug from its pre-clinical development to its established use by phase III clinical trials. Based on the latest evidence, we will present its mechanism of action, its efficacy and its toxicity profile on treated myeloma patients and we will try to reply to all raised concerns about its current use.

Expert opinion: Either alone or in combination with other agents, carfilzomib seems to be an effective and safe therapeutic option for MM management. Results of ongoing trials are expected to update its application, even at an earlier level of the disease course.

KEYWORDS:

• Carfilzomib
• multiple myeloma
• proteasome inhibitor
• relapsed/refractory
• newly diagnosed

Declaration of interest

MA Dimopoulos has received honoraria from Janssen, Takeda, Celgene, Amgen. E Kastritis has received honoraria from Janssen, Takeda and Amgen. E Terpos has received honoraria from Celgene, Janssen, Takeda, and Amgen. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. A reviewer on this manuscript has disclosed honoraria from Amgen (the European Manufacturer of Carfilzomib).

Additional information

Funding

This paper was not funded.