Cardiotoxicity associated with carfilzomib: systematic review and meta-analysis

Leukemia & Lymphoma
Chintan ShahJan S Moreb

Abstract

Carfilzomib is a second-generation proteasome inhibitor (PI) that is approved for patients with relapsed or refractory multiple myeloma (RRMM) who failed ≥1 prior lines of therapy. We performed a systematic review of carfilzomib literature with meta-analysis to determine cumulative incidence of cardiotoxicity. After the literature search, we included a total of 29 eligible phase I/II, phase II and phase III clinical trials which used carfilzomib. The cumulative incidence and overall odds ratios (OR) were calculated with random effect model, using 'R' software with metaphor package. A total of 4164 patients with various malignancies were included. The overall estimated cumulative incidence of cardiotoxicity was 8.68% and 4.92%, respectively, for all-grade and high-grade (≥ grade 3) toxicity, which seems higher than other PIs. Compared to control group, the odds of developing cardiotoxicity due to carfilzomib was significantly higher with OR of 2.03 (95% CI: 1.19-3.46, p = .010) and 2.04 (95% CI: 1.31-3.17, p = .002) for all-grades and high grades, respectively. Concomitant immunomodulatory agents seem to increase the risk of cardiotoxicity (high-grade cardiotoxicity 6.45% and 4.34% with and without concomitant immunomodulatory a...Continue Reading

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Citations

Oct 12, 2018·Panminerva Medica·Mohammed A AljamaDavid Dingli
Jan 8, 2019·Leukemia & Lymphoma·Jingmei XieJie Jiang
Apr 19, 2019·Therapeutic Advances in Cardiovascular Disease·Chintan P Shah, Jan S Moreb
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Jun 10, 2020·Herz·Lars MichelTienush Rassaf
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