Complete Response (CR) and Minimal Residual Disease Neg (MRDneg) CR Rates at Treatment Intervals With Carfilzomib, Lenalidomide & Dexamethasone (CRd) in New Multiple Myeloma Patients After 8 Cycles of Induction, 1 Year Maintenance, and 2 Years Maintenance
Carfilzomib, Lenalidomide, and Dexamethasone in New Multiple Myeloma Patients · Source last updated 2021-03-02
Results reported by the registry submitting party. Population, time horizon, units and missing values must be read together.
Measure
NUMBER
Unit
percentage of participants
Interval / dispersion
95% Confidence Interval
Time frame
up to 2 years
What was measured
Response is assessed by the International Myeloma Working Group Criteria. MRD is defined by M-spike, plasma cell burden, and abnormal free light chains (FLC). Complete response is negative immunofixation on serum, and urine and disappearance of any soft tissue plasmacytomas and ≤ 5% plasma cells in bone marrow. Stringent complete response (sCR) is normal FLC ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence. Near complete response (nCR) is the absence of myeloma protein on electrophoresis, independent of immunofixation status. Very good partial response (VGPR) is serum and urine M-protein detectable by immunofixation but not on electrophoresis or 90% or greater reduction in serum M-protein plus urine M-protein level \<100mg per 24h. Overall response rate (ORR) is patients who attained a partial response (PR) (≥50% reduction of serum M-protein and reduction in 24h urinary M-protein) or better (BoR) response.
Analysis population: \*Six patients withdrew from the study, four due to non-compliance and two to continue treatment at another institution. 'One patient refused to have a bone marrow biopsy procedure and one patient withdrew due to non-compliance. CR (n=0) after 8 cycles.
Groups in this outcome
Carfilzomib, Lenalidomide, and Dexamethasone
Patients will receive 8 cycles of induction combination therapy of carfilzomib, lenalidomide, and dexamethasone (CRd). Patients achieving stable disease or better after 8 cycles of CRd will receive lenalidomide extended dosing (phase I) for 12 cycles. After 12 cycles, patients will have the option to continue extended dosing (phase II) for one additional year Carfilzomib: Cycle 1: 20 mg/m(2) intravenous (IV) infusion over 30 minutes on days 1 and 2, then 36 mg/m(2) IV on days 8, 9, 15, and 16 Cycle 2-8: 36mg/ m(2) IV infusion over 30 minutes on days 1, 2, 8, 9, 15, and 16 Lenalidomide: Cycle 1: 25 mg oral days 2-21 of 28-day cycle; Cycle 2 - 8: 25 mg oral days 1-21 of 28-day cycle; After 8 cycles of combination carfilzomib, lenalidomide, and dexamethasone (CRd), patients may continue Lenalidomide for 12 cycles; After 12 cycles of extended dosing of Lenalidomide, patients may continue Lenalidomide for one year Dexamethasone: Cycle 1: 20 mg oral or IV on days 2, 8, 9, 15, 16, 22,
Group identifiers and denominators belong to this outcome only. They may differ in another outcome or in safety reporting.
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
45
Reported measurements
sCR/CR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
21
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
46.7
Not reported
31.7
62.1
Not reported
MRDnegCR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
20
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
44.4
Not reported
29.6
60.0
Not reported
nCR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
9
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
20
Not reported
9.6
34.6
Not reported
≥VGPR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
40
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
89
Not reported
75.6
96.3
Not reported
ORR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
44
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
97.8
Not reported
88.2
99.9
Not reported
sCR after 8 cycles
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
21
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
46.7
Not reported
31.7
62.1
Not reported
sCR/CR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
28
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
62.2
Not reported
46.5
76.2
Not reported
sCR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
27
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
60.0
Not reported
44.3
74.3
Not reported
CR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
1
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
2.2
Not reported
0
11.8
Not reported
MRDnegCR after 1 year'
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
23
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
53.5
Not reported
37.7
68.8
Not reported
nCR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
5
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
11.1
Not reported
3.7
24.1
Not reported
≥VGPR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
40
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
89
Not reported
75.6
96.3
Not reported
ORR after 1 year
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
44
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
97.8
Not reported
88.2
99.9
Not reported
sCR/CR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
29
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
64.4
Not reported
48.8
78.1
Not reported
sCR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
28
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
62.2
Not reported
46.5
76.2
Not reported
CR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
1
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
2.2
Not reported
0
11.8
Not reported
MRDnegCR after 2 years*
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
18
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
46.2
Not reported
30.1
62.8
Not reported
nCR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
5
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
11.1
Not reported
3.7
24.1
Not reported
≥VGPR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
41
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
91.1
Not reported
78.8
97.5
Not reported
ORR after 2 years
Analysis denominator · Participants
Group
Source count
Carfilzomib, Lenalidomide, and Dexamethasone
44
Values in percentage of participants · Interval/dispersion: 95% Confidence Interval
Group
Value
Spread
Lower
Upper
Comment
Carfilzomib, Lenalidomide, and Dexamethasone
97.8
Not reported
88.2
99.9
Not reported
Complete source fields
classes
categories
measurements
group Id
OG000
lower Limit
31.7
upper Limit
62.1
value
46.7
denoms
counts
group Id
OG000
value
21
units
Participants
title
sCR/CR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
29.6
upper Limit
60.0
value
44.4
denoms
counts
group Id
OG000
value
20
units
Participants
title
MRDnegCR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
9.6
upper Limit
34.6
value
20
denoms
counts
group Id
OG000
value
9
units
Participants
title
nCR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
75.6
upper Limit
96.3
value
89
denoms
counts
group Id
OG000
value
40
units
Participants
title
≥VGPR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
88.2
upper Limit
99.9
value
97.8
denoms
counts
group Id
OG000
value
44
units
Participants
title
ORR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
31.7
upper Limit
62.1
value
46.7
denoms
counts
group Id
OG000
value
21
units
Participants
title
sCR after 8 cycles
categories
measurements
group Id
OG000
lower Limit
46.5
upper Limit
76.2
value
62.2
denoms
counts
group Id
OG000
value
28
units
Participants
title
sCR/CR after 1 year
categories
measurements
group Id
OG000
lower Limit
44.3
upper Limit
74.3
value
60.0
denoms
counts
group Id
OG000
value
27
units
Participants
title
sCR after 1 year
categories
measurements
group Id
OG000
lower Limit
0
upper Limit
11.8
value
2.2
denoms
counts
group Id
OG000
value
1
units
Participants
title
CR after 1 year
categories
measurements
group Id
OG000
lower Limit
37.7
upper Limit
68.8
value
53.5
denoms
counts
group Id
OG000
value
23
units
Participants
title
MRDnegCR after 1 year'
categories
measurements
group Id
OG000
lower Limit
3.7
upper Limit
24.1
value
11.1
denoms
counts
group Id
OG000
value
5
units
Participants
title
nCR after 1 year
categories
measurements
group Id
OG000
lower Limit
75.6
upper Limit
96.3
value
89
denoms
counts
group Id
OG000
value
40
units
Participants
title
≥VGPR after 1 year
denoms
counts
group Id
OG000
value
45
units
Participants
description
Response is assessed by the International Myeloma Working Group Criteria. MRD is defined by M-spike, plasma cell burden, and abnormal free light chains (FLC). Complete response is negative immunofixation on serum, and urine and disappearance of any soft tissue plasmacytomas and ≤ 5% plasma cells in bone marrow. Stringent complete response (sCR) is normal FLC ratio and absence of clonal cells in bone marrow by immunohistochemistry or immunofluorescence. Near complete response (nCR) is the absence of myeloma protein on electrophoresis, independent of immunofixation status. Very good partial response (VGPR) is serum and urine M-protein detectable by immunofixation but not on electrophoresis or 90% or greater reduction in serum M-protein plus urine M-protein level \<100mg per 24h. Overall response rate (ORR) is patients who attained a partial response (PR) (≥50% reduction of serum M-protein and reduction in 24h urinary M-protein) or better (BoR) response.
dispersion Type
95% Confidence Interval
groups
description
Patients will receive 8 cycles of induction combination therapy of carfilzomib, lenalidomide, and dexamethasone (CRd). Patients achieving stable disease or better after 8 cycles of CRd will receive lenalidomide extended dosing (phase I) for 12 cycles. After 12 cycles, patients will have the option to continue extended dosing (phase II) for one additional year Carfilzomib: Cycle 1: 20 mg/m(2) intravenous (IV) infusion over 30 minutes on days 1 and 2, then 36 mg/m(2) IV on days 8, 9, 15, and 16 Cycle 2-8: 36mg/ m(2) IV infusion over 30 minutes on days 1, 2, 8, 9, 15, and 16 Lenalidomide: Cycle 1: 25 mg oral days 2-21 of 28-day cycle; Cycle 2 - 8: 25 mg oral days 1-21 of 28-day cycle; After 8 cycles of combination carfilzomib, lenalidomide, and dexamethasone (CRd), patients may continue Lenalidomide for 12 cycles; After 12 cycles of extended dosing of Lenalidomide, patients may continue Lenalidomide for one year Dexamethasone: Cycle 1: 20 mg oral or IV on days 2, 8, 9, 15, 16, 22,
id
OG000
title
Carfilzomib, Lenalidomide, and Dexamethasone
param Type
NUMBER
population Description
\*Six patients withdrew from the study, four due to non-compliance and two to continue treatment at another institution. 'One patient refused to have a bone marrow biopsy procedure and one patient withdrew due to non-compliance. CR (n=0) after 8 cycles.
reporting Status
POSTED
time Frame
up to 2 years
title
Complete Response (CR) and Minimal Residual Disease Neg (MRDneg) CR Rates at Treatment Intervals With Carfilzomib, Lenalidomide & Dexamethasone (CRd) in New Multiple Myeloma Patients After 8 Cycles of Induction, 1 Year Maintenance, and 2 Years Maintenance