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Incidence and Management of Adverse Events Associated With Single-Agent Carfilzomib in Relapsed and/or Refractory Multiple Myeloma

The supplement and associated publication costs were funded by Onyx Pharmaceuticals.

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This series of articles provides clinicians with a resource for the use of carfilzomib in the management of patients with multiple myeloma.

The adverse event profile of single-agent carfilzomib suggests that the agent is an important treatment option for patients with advanced multiple myeloma, particularly those with pre-existing peripheral neuropathy or those who are at risk for the development of peripheral neuropathy.

This article reviews the hematologic safety profile of carfilzomib in patients with relapsed/refractory multiple myeloma, as assessed in a cross-trial safety analysis of four phase II studies, and makes recommendations for the appropriate management of hematologic adverse events.

This article reviews the etiology and incidence of renal adverse events in patients with multiple myeloma, the renal safety profile of single-agent carfilzomib from four phase II studies in patients with relapsed and/or refractory multiple myeloma, and the management of patients with multiple myeloma who receive carfilzomib and are at risk for renal complications.

This article presents an overview of the cardiac and pulmonary safety profile of single-agent carfilzomib therapy in patients with relapsed and/or refractory multiple myeloma from an analysis of four phase II clinical studies, and provides practical recommendations for the management of patients at risk for cardiac events and pulmonary complication.

Multiple myeloma (MM) is a malignant, progressive plasma cell tumor characterized by overproduction of monoclonal immunoglobulins, osteolytic bone lesions, renal disease, and immunodeficiency.[1] Before the 1980s, patients with MM experienced a slow, progressive decline in quality of life until death approximately 2 years after diagnosis.

Bortezomib (Velcade), the first-in-class inhibitor of the proteasome,[1] or multicatalytic proteinase complex,[2] was originally found to be active against relapsed and relapsed/refractory multiple myeloma as a single agent in phase I through III clinical trials.[3-6

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