Carfilzomib for the Treatment of Multiple Myeloma: Systematic Review of the Literature and Colombian Experience Based on RIPS

Carfilzomib for the Treatment of Multiple Myeloma: Systematic Review of the Literature and Colombian Experience Based on RIPS

Introduction: Multiple myeloma is a B-cell malignant and progressive tumor, associated with osteolytic lesions, immunodeficiency and renal dysfunction, that has been treated since 2008 with Bortezomib, which achieved an increase in patients survival, however its use was limited due to dose dependent...

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Translated title: Carfilzomib en el tratamiento de mieloma múltiple: revisión sistemática de la literatura y experiencia colombiana basada en RIPS
Journal Title: MedUNAB
First author: Camilo Castaneda
Other Authors: María Camila Pantoja;
Luzmila Montaño;
Diego Rosselli
Traslated keyword:
Language: Undetermined
Get full text: https://revistas.unab.edu.co/index.php/medunab/article/view/2306
Resource type: Journal Article
Source: MedUNAB; Vol 17, No 2 (Year 2014).
DOI: http://dx.doi.org/10.29375/01237047.2306
Publisher: Universidad Autónoma de Bucaramanga
Usage rights: Reconocimiento (by)
Categories: Health Sciences --> Medicine, General --AMP-- Internal
Health Sciences --> Nursing
Health Sciences, Social Sciences/Humanities --> Psychology, Clinical
Abstract: Introduction: Multiple myeloma is a B-cell malignant and progressive tumor, associated with osteolytic lesions, immunodeficiency and renal dysfunction, that has been treated since 2008 with Bortezomib, which achieved an increase in patients survival, however its use was limited due to dose dependent adverse effects, especially painful peripheral neuropathy, it has recently come into use Carfilzomib (a second generation proteasome inhibitor agent) approved by the FDA in 2012 as the only agent for treatment of refractory disease and relapsing of multiple myeloma. Objective: To conduct a literature review and determine the Colombian experience with the drug Carfilzomib, considering national statistics contained in the individual records of health service delivery, plus the status of a case is described. Methodology: for the review was considered literature indexed in PubMed, as an inclusion criterion was considered clinical studies Phase 2 and 3 that reviewed Carfilzomib in handling multiple myeloma. Regarding the Colombian experience, taking information provided by Biotoscana, 37 multiple myeloma Colombian patients diagnosed between 2003 and 2012 and who had been prescribed Carfilzomib were identified. Results: A total of eight randomized trials shown on hematologic adverse effects such as fatigue (367 of 678 patients, 54%), and nausea (323 patients, 48%). For the RIPS of 37 patients, 22 patients received 1 to 8 cycles Carfilzomib (3.0 average, median 3). Clinical response in 9 of them, 4 patients (22%) very good partial response, 4 patients (22%) partial response, 1 patient (6%) with stable disease was assessed. Conclusions: We found difference between the side effects reported in Colombia from the ones who have been reported globally, fatigue prevails in our patients, also experience with new drugs has not been sufficiently documented.[Castaeda C, Pantoja MC, Montao L, Rosselli D. Carfilzomib for the Treatment of Multiple Myeloma: Systematic Review of the Literature and Colombian Experience Based on RIPS. MedUNAB 2015; 17(2):99-106]
Translated abstract: Introduccin: El mieloma mltiple es un tumor maligno y progresivo de las clulas B asociado a lesiones osteolticas, inmunodeficiencia y disfuncin renal que ha sido tratado desde 2008 con bortezomib con el cual se logr un aumento del tiempo de sobrevida de los pacientes, sin embargo su uso se vio limitado por efectos adversos dependientes de la dosis, en especial la neuropata perifrica dolorosa. Recientemente ha entrado en uso carfilzomib (agente inhibidor de proteosoma de segunda generacin) aprobado por la FDA en 2012 como agente nico para tratamiento de enfermedad refractaria y recadas de mieloma mltiple. Objetivo: Realizar una revisin de la literatura y determinar la experiencia colombiana con el medicamento carfilzomib teniendo en cuenta las estadsticas nacionales consignadas en los registros individuales de prestacin de servicios de salud. Adems se describe la situacin de un caso clnico. Metodologa: La revisin se hizo con base en literatura indexada en PubMed; como criterio de inclusin se tuvo en cuenta que los artculos a revisar fueran estudios clnicos de fase 2 y 3 de carfilzomib en manejo de mieloma mltiple. Respecto a la experiencia colombiana se identificaron 37 pacientes colombianos con mieloma mltiple diagnosticado entre 2003 y 2012 y a quienes se hubiera prescrito carfilzomib, teniendo en cuenta informacin proporcionada por Biotoscana. Resultados: En total se localizaron 8 estudios clnicos con asignacin al azar que evidencian efectos adversos no hematolgicos como fatiga (367 de los 678 pacientes, 54%), y nusea (323 pacientes, 48%). En el caso de los RIPS, de los 37 pacientes, 22 pacientes recibieron de 1 a 8 ciclos de carfilzomib (promedio 3.0, mediana 3). Se evalu la respuesta clnica en 9 de ellos, encontrndose 4 pacientes (22%) en respuesta parcial muy buena, 4 pacientes (22%) en respuesta parcial, 1 paciente (6%) con enfermedad estable. Conclusiones: Se encontr diferencia entre los efectos adversos que se reportan en Colombia y los que se han reportado globalmente, predominando en nuestros pacientes la fatiga; asimismo se concluye que la experiencia con nuevos medicamentos no ha sido suficientemente documentada. [Castaeda C, Pantoja MC, Montao L, Rosselli D. Carfilzomib en el tratamiento de mieloma mltiple: revisin sistemtica de la literatura y experiencia colombiana basada en RIPS. MedUNAB 2015; 17(2):99-106]