[Clinical Study on the Transition of First-Line Bortezomib Intole- rance to Carfilzomib in the Treatment of Multiple Myeloma].

In-class transition from bortezomib to carfilzomib led to progressive resolution of peripheral neuropathy, with complete disappearance of painful symptoms in all patients by 4 months post-transition.

• 23 MM patients were included, with 22 cases of intolerance due to peripheral neuropathy (PN) and 1 case of diarrhea
• At 1 month, 2 months, and 4 months post-transition, 1/22, 3/22, and 12/20 of patients had PN reduced by one grade, respectively
• At 4 months after transition, all patients' peripheral neuropathic pain symptoms had disappeared
• Median treatment cycles of bortezomib before transition was 4 (range 1-6)
• Median follow-up was 10 (range 2-23) months

ONLS and TNS scores showed significant improvement after 2 months of transition to carfilzomib compared to baseline.

• Both overall neuropathy limitations scale (ONLS) and total neuropathy score (TNS) scores decreased significantly after 2 months of transition
• P <0.001 for both ONLS and TNS score reductions compared to baseline
• The cohort had a median age of 63 (range 46-75) years

Grade ≥3 neutropenia decreased after switching from bortezomib to carfilzomib.

• Grade ≥3 neutropenia decreased from 21.7% to 17.4% after carfilzomib treatment
• P=0.021 for this reduction in grade ≥3 neutropenia

Carfilzomib was associated with additional non-hematological toxicities that were transient in nature.

• Grade 1-2 hypertension occurred in 47.8% of patients (11/23 cases)
• QTcF prolongation occurred in 13.0% of patients (3/23 cases)
• All additional non-hematological toxicity was described as transient

Transition to carfilzomib significantly deepened treatment response, increasing complete remission rates and MRD negativity.

• The ≥CR (complete remission) conversion rate increased from 30.4% to 69.5% after transition (P=0.047)
• The sCR (stringent complete remission) rate increased from 30.4% to 65.2% (P=0.026)
• The minimal residual disease (MRD) negative conversion rate also increased from 30.4% to 65.2% (P=0.026)