carfilzomib; lenalidomide; dexamethasone; relapsed multiple myeloma; clinical trial

A primary analysis of the ASPIRE study found that the addition of carfilzomib to lenalidomide and dexamethasone (carfilzomib group) significantly improved progression-free survival (PFS) compared with lenalidomide and dexamethasone alone (control group) in patients with relapsed multiple myeloma (RMM). This post hoc analysis examined outcomes from ASPIRE in patients categorised by age. In the carfilzomib group, 103/396 patients were 70years old, and in the control group, 115/396 patients were 70years old. Median PFS for patients <70years old was 286months for the carfilzomib group versus 176months for the control group [hazard ratio (HR), 0701]. Median PFS for patients 70years old was 238months for the carfilzomib group versus 160months for the control group (HR, 0753). For patients <70years the overall response rate (ORR) was 860% (carfilzomib group) and 669% (control group); for patients 70years old the ORR was 903% (carfilzomib group) and 661% (control group). Within the carfilzomib group, grade 3 cardiovascular adverse events occurred more frequently among patients 70years old compared with patients <70years old. Carfilzomib-lenalidomide-dexamethasone has a favourable benefit-risk profile for patients with RMM, including elderly patients 70years old. Trial Registration: clinicaltrials.gov identifier: NCT01080391.