To characterize safety associated with the use of Kyprolis under the locally approved label.
Kyprolis® (K; carfilzomib) was approved in India on 17 January 2017 as a prescription medication in combination with dexamethasone (Kd) or with lenalidomide (Revlimid®) plus dexamethasone (KRd) for the treatment of patients with relapsed or refractory multiple myeloma (RRMM) following 1 to 3 prior lines of therapy. This non-comparative, interventional phase 4 study is designed to fulfil the post-marketing requirement to assess safety, tolerability, and efficacy of Kyprolis on Indian subjects with RRMM as per the locally approved label.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
101
Drug: Carfilzomib + Dexamethasone * Carfilzomib will be administered as a 30-minute infusion. * Dexamethasone will be taken by mouth or intravenously.
Drug: Carfilzomib + Lenalidomide + Dexamethasone * Carfilzomib will be administered as a 10 minute infusion. * Lenalidomide will be taken orally. * Dexamethasone will be taken by mouth or intravenously.
Yashoda Hospital
Hyderabad, Andhra Pradesh, India
Apollo Hospital
Hyderabad, Andhra Pradesh, India
Number of Participants Who Experienced Treatment-emergent Adverse Events (TEAEs)
A TEAE was any untoward medical occurrence in a clinical trial participant after the first dose of investigational product (IP) irrespective of a causal relationship with the IP. TEAEs were graded using National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v.4.03. Any clinically significant laboratory changes over time were recorded as TEAEs.
Time frame: From the first dose date of any IP until the end of trial; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Number of Participants Who Experienced Serious TEAEs
A serious TEAE was any untoward medical occurrence in a clinical trial participant after first dose of IP irrespective of a causal relationship with the IP(s), that resulted in death, was immediately life threatening, required in-patient hospitalization or prolongation of existing hospitalization, resulted in persistent or significant disability/incapacity, a congenital anomaly/birth defect, or another medically important serious event.
Time frame: From the first dose date of any IP until the end of trial; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Progression Free Survival (PFS) as Per International Myeloma Working Group-Uniform Response Criteria (IMWG-URC)
PFS was defined as the time from first dose of IP until the earliest date of disease progression (PD) or death due to any cause. PD was per IMWG-URC, with progression assessments at intervals as per local standard of care. PD: increase of 25% from lowest response value in serum M-component and/or urine M-component and/or only in participants without measurable serum and urine M protein levels: the difference between involved and uninvolved free light chain (FLC) levels and/or only in participants without measurable serum and urine M-protein levels and without measurable disease by FLC levels, bone marrow (BM) plasma cell percentage; definite development of new bone lesions or soft tissue plasmacytomas; development of hypercalcemia. Medians were estimated using the Kaplan-Meier method. Corresponding 95% confidence intervals (CIs) were estimated using the method by Klein and Moeschberger (1997) with log-log transformation.
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M S Ramaiah Memorial Hospital
Bangalore, Karnataka, India
K L E S Dr Prabhakar Kore Hospital and Medical Research Centre
Belagavi, Karnataka, India
Cytecare Cancer Hospitals
Bengaluru, Karnataka, India
Aster Medcity
Kochi, Kerala, India
Government Medical College
Kozhikode, Kerala, India
Tata Memorial Hospital
Mumbai, Maharashtra, India
Mumbai Oncocare Center
Mumbai, Maharashtra, India
Navsanjeevani Hospital
Nashik, Maharashtra, India
...and 7 more locations
Time frame: From enrollment until the end of trial or death date, whichever occurred earlier; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Overall Response Rate (ORR) as Per IMWG-URC
ORR was defined as the percentage of participants for whom the best overall response was a stringent complete response (sCR), complete response (CR), very good partial response (VGPR), or partial response (PR) as determined by the IMWG-URC. CR: negative immunofixation on serum and urine, soft tissue plasmacytomas disappearance, \< 5% plasma cells in bone marrow (BM). sCR: CR and normal serum free light chain ratio and no clonal cells in BM by immunohistochemistry. VGPR: Serum and urine M-protein detectable by immunofixation or ≥ 90% reduction in serum M-protein (urine M-protein level \< 100 mg/24-hours). PR: ≥ 50% reduction of serum M-protein and reduction in 24-hours urinary M-protein by ≥ 90% or to \< 200 mg/24-hours. The ORR 95% CIs were estimated using the Clopper-Pearson method.
Time frame: From the first dose date of any IP until the end of trial; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Clinical Benefit Rate (CBR) as Per IMWG-URC
CBR was defined as the percentage of participants with either the best overall response of sCR, CR, VGPR, PR, and minimal response (MR) as determined by the IMWG-URC. CR: negative immunofixation on serum and urine, soft tissue plasmacytomas disappearance, \< 5% plasma cells in BM. sCR: CR and normal serum free light chain ratio and no clonal cells in BM by immunohistochemistry. VGPR: Serum and urine M-protein detectable by immunofixation or ≥ 90% reduction in serum M-protein (urine M-protein level \< 100 mg/24-hours). PR: ≥ 50% reduction of serum M-protein and reduction in 24-hours urinary M-protein by ≥ 90% or to \< 200 mg/24-hours. MR: ≥ 25% but ≤ 49% reduction of serum M-protein and reduction in 24-hour urinary M-protein by 50% to 89%. The CBR 95% CIs were estimated using the Clopper-Pearson method.
Time frame: From the first dose date of any IP until the end of trial; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Time to Response (TTR) as Per IMWG-URC
TTR was defined as the time from first dose date to the earliest date when confirmed sCR, CR, VGPR, or PR was first achieved. CR: negative immunofixation on serum and urine, soft tissue plasmacytomas disappearance, \< 5% plasma cells in BM. sCR: CR and normal serum free light chain ratio and no clonal cells in BM by immunohistochemistry. VGPR: Serum and urine M-protein detectable by immunofixation or ≥ 90% reduction in serum M-protein (urine M-protein level \< 100 mg/24-hours). PR: ≥ 50% reduction of serum M-protein and reduction in 24-hours urinary M-protein by ≥ 90% or to \< 200 mg/24-hours. Medians were estimated using the Kaplan-Meier method.
Time frame: From the first dose date of any IP until the end of trial; median (min, max) time on trial was 8.7 (0.1, 37.2) months
Duration of Response (DOR) as Per IMWG-URC
DOR was defined as the time from first evidence of PR or better as per IMWG-URC to the earliest of PD or death due to any cause for participants with a best response of PR or better. PD: increase of 25% from lowest response value in serum M-component and/or urine M-component and/or only in participants without measurable serum and urine M protein levels: the difference between involved and uninvolved FLC levels and/or only in participants without measurable serum and urine M-protein levels and without measurable disease by FLC levels, bone marrow plasma cell percentage; definite development of new bone lesions or soft tissue plasmacytomas; development of hypercalcemia. Medians were estimated using the Kaplan-Meier method. Corresponding 95% CIs were estimated using the method by Klein and Moeschberger (1997) with log-log transformation.
Time frame: From enrollment until the end of trial or death date, whichever occurred earlier; median (min, max) time on trial was 8.7 (0.1, 37.2) months