Carfilzomib-associated cardiovascular adverse events occurred in 6.5% of multiple myeloma patients in a multicenter retrospective cohort, with baseline heart failure being a significantly increased risk factor, supporting a risk-adapted cardio-oncology approach particularly in patients with pre-existing cardiac dysfunction.
Carfilzomib-associated cardiovascular adverse events (CVAEs) occurred in 6.5% of multiple myeloma patients treated with carfilzomib.
Heart failure was the most common cardiovascular adverse event manifestation, followed by arrhythmias and acute coronary syndromes.
The median time to onset of carfilzomib-associated CVAEs was 114 days.
Baseline heart failure was a statistically significant risk factor for the development of carfilzomib-associated CVAEs.
CVAEs were associated with numerically inferior overall survival, though the difference was not statistically significant.
Partial recovery of left ventricular ejection fraction was observed following carfilzomib treatment discontinuation.
This research examined how often a multiple myeloma drug called carfilzomib causes heart problems and what factors put patients at higher risk. Researchers looked at records from 385 multiple myeloma patients treated at three U.S. hospitals between 2020 and 2024. They found that about 1 in 15 patients (6.5%) developed a significant heart problem while on carfilzomib, with heart failure being the most common issue. These heart problems typically appeared about four months (114 days) after starting the drug. The study found that patients who already had heart failure before starting carfilzomib were significantly more likely to develop heart problems from the drug. Interestingly, traditional heart disease risk factors like high blood pressure, diabetes, or high cholesterol were not independently linked to higher risk in this analysis. When patients stopped taking carfilzomib after developing heart problems, their heart function partially recovered, suggesting the cardiac effects may be at least partly reversible. This research suggests that doctors and patients should be aware that carfilzomib can cause heart problems, particularly in people who already have heart disease before treatment begins. The findings point toward the value of a specialized 'cardio-oncology' approach — where cancer doctors and heart specialists work together — especially for patients with existing heart conditions. Closer monitoring during the first several months of treatment may help detect and address heart problems early, potentially reducing serious harm while still allowing patients to benefit from this effective cancer drug.
Lad N, Esplund J, Grauer D, Atrash S, Mewawalla P, Gadela T, et al.. (2026). Incidence and Associated Risk Factors in the Development of Carfilzomib-Induced Cardiovascular Toxicity.. Current oncology (Toronto, Ont.). https://doi.org/10.3390/curroncol33080471