@article {7069, title = {Carfilzomib significantly improves the progression-free survival of high-risk patients in multiple myeloma}, journal = {Blood}, volume = {128}, year = {2016}, note = {Cited By :2Export Date: 18 February 2017References: Pulte, D., Gondos, A., Brenner, H., Improvement in survival of older adults with multiple myeloma: Results of an updated period analysis of SEER data (2011) Oncologist, 16 (11), pp. 1600-1603;Stewart, A.K., Rajkumar, S.V., Dimopoulos, M.A., Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myeloma (2015) N Engl J Med., 372 (2), pp. 142-152; Dimopoulos, M.A., Weisel, K.C., Song, K.W., Cytogenetics and long-term survival of patients with refractory or relapsed and refractory multiple myeloma treated with pomalidomide and low-dose dexamethasone (2015) Haematologica, 100 (10), pp. 1327-1333; Avet-Loiseau, H., Attal, M., Moreau, P., Genetic abnormalities and survival in multiple myeloma: The experience of the Intergroupe Francophone du My{\'e}Lome (2007) Blood, 109 (8), pp. 3489-3495; 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Lonial, S., Dimopoulos, M., Palumbo, A., Elotuzumab therapy for relapsed or refractory multiple myeloma (2015) N Engl J Med., 373 (7), pp. 621-631; Moreau, P., Masszi, T., Grzasko, N., Oral ixazomib, lenalidomide, and dexamethasone for multiple myeloma (2016) N Engl J Med., 374 (17), pp. 1621-1634; Jakubowiak, A.J., Dytfeld, D., Griffith, K.A., A phase 1/2 study of carfilzomib in combination with lenalidomide and low-dose dexamethasone as a frontline treatment for multiple myeloma (2012) Blood, 120 (9), pp. 1801-1809; Korde, N., Roschewski, M., Zingone, A., Treatment with carfilzomib-lenalidomide dexamethasone with lenalidomide extension in patients with smoldering or newly diagnosed multiple myeloma (2015) JAMA Oncol., 1 (6), pp. 746-754 }, month = {2016}, pages = {1174 - 1180}, abstract = {The presence of certain high-risk cytogenetic abnormalities, such as translocations (4;14) and (14;16) and deletion (17p), are known to have a negative impact on survival in multiple myeloma (MM). The phase 3 study ASPIRE (N = 792) demonstrated that progression-free survival (PFS) was significantly improved with carfilzomib, lenalidomide, and dexamethasone (KRd), compared with lenalidomide and dexamethasone (Rd) in relapsed MM. This preplanned subgroup analysis of ASPIRE was conducted to evaluate KRd vs Rd by baseline cytogenetics according to fluorescence in situ hybridization. Of 417 patients with known cytogenetic risk status, 100 patients (24\%) were categorized with high-risk cytogenetics (KRd, n548; Rd, n552) and 317 (76\%) were categorized with standard-risk cytogenetics (KRd, n = 147; Rd, n = 170). For patients with high-risk cytogenetics, treatment with KRd resulted in a median PFS of 23.1 months, a 9-month improvement relative to treatment with Rd. For patients with standard-risk cytogenetics, treatment with KRd led to a 10-month improvement in median PFS vs Rd. The overall response rates for KRd vs Rd were 79.2\% vs 59.6\% (high-risk cytogenetics) and 91.2\% vs 73.5\% (standardrisk cytogenetics); approximately fivefold as many patients with high- or standard-risk cytogenetics achieved a complete response or better with KRd vs Rd (29.2\% vs 5.8\% and 38.1\% vs 6.5\%, respectively). KRd improved but did not abrogate the poor prognosis associated with high-risk cytogenetics. This regimen had a favorable benefit-risk profile in patients with relapsed MM, irrespective of cytogenetic risk status, and should be considered a standard of care in these patients. Copyright {\textcopyright} 2011 by the American Association for the Advancement of Science; all rights reserved.}, url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84987732917\&doi=10.1182\%2fblood-2016-03-707596\&partnerID=40\&md5=6a512c8b907cd89ef365850934e4465a}, author = {Avet-Loiseau, H. and Fonseca, R. and Siegel, D. and Dimopoulos, M.A. and {\v S}pi{\v c}ka, I. and Masszi, T. and H{\'a}jek, R. and Rosi{\~n}ol, L. and Goranova-Marinova, V. and Mihaylov, G. and Maisnar, V. and Mateos, M.-V. and Wang, M. and Niesvizky, R. and Oriol, A. and Jakubowiak, A. and Minarik, J. and Palumbo, A. and Bensinger, W. and Kukreti, V. and Ben-Yehuda, D. and Stewart, A.K. and Obreja, M. and Moreau, P.} }