Dr. Chari Discusses the Importance of the ARROW Trial in Myeloma

Ajai Chari, MD
Published: Friday, Nov 16, 2018



Ajai Chari, MD, associate professor of medicine, Hematology and Medical Oncology, Mount Sinai Hospital, discusses the importance of the ARROW trial in multiple myeloma.

Findings from the phase III ARROW trial led to the FDA approval of the once-weekly dosing option of carfilzomib (Kyprolis) for use in combination with dexamethasone in patients with relapsed/refractory myeloma. In the study, the dose of once-weekly carfilzomib at 70 mg/m2 with dexamethasone resulted in a prolonged progression-free survival compared with the standard twice-weekly schedule in this patient population.

Chari says this trial is important because when carfilzomib was originally being studied, there were concerns about cytokine release syndrome, tumor lysis, and renal dysfunction. Step-up dosing was implemented along with hydration and tumor lysis prophylaxis. Carfilzomib was approved following these implementations on a twice-weekly regimen, but Chari notes that giving patients chemotherapy twice per week indefinitely is challenging from a practically point of view. This trial addressed the idea of giving this drug once per week over 30 minutes as opposed to twice per week for 10 minutes. Efficacy was not only maintained, but it was superior to the approved dosing schedule, says Chari.
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Ajai Chari, MD, associate professor of medicine, Hematology and Medical Oncology, Mount Sinai Hospital, discusses the importance of the ARROW trial in multiple myeloma.

Findings from the phase III ARROW trial led to the FDA approval of the once-weekly dosing option of carfilzomib (Kyprolis) for use in combination with dexamethasone in patients with relapsed/refractory myeloma. In the study, the dose of once-weekly carfilzomib at 70 mg/m2 with dexamethasone resulted in a prolonged progression-free survival compared with the standard twice-weekly schedule in this patient population.

Chari says this trial is important because when carfilzomib was originally being studied, there were concerns about cytokine release syndrome, tumor lysis, and renal dysfunction. Step-up dosing was implemented along with hydration and tumor lysis prophylaxis. Carfilzomib was approved following these implementations on a twice-weekly regimen, but Chari notes that giving patients chemotherapy twice per week indefinitely is challenging from a practically point of view. This trial addressed the idea of giving this drug once per week over 30 minutes as opposed to twice per week for 10 minutes. Efficacy was not only maintained, but it was superior to the approved dosing schedule, says Chari.



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