Oncology (Williston Park). 2013 Dec;27 Suppl 3:19-23.
Patients with multiple myeloma (MM) frequently experience renal dysfunction owing to patient-specific risk factors, the pathophysiology of MM, and treatment-related adverse events. The presence of renal complications in patients with MM may be associated with advanced disease and is a negative prognostic factor for survival. Frequently these patients receive reduced or modified dosing regimens, which can result in under-dosing and may adversely affect treatment efficacy. Consequently, there is a need for effective therapies with favorable renal safety profiles. Carfilzomib is a selective proteasome inhibitor approved in the United States as a single agent for the treatment of relapsed and refractory MM. Safety studies have demonstrated that single-agent carfilzomib is well tolerated in patients with relapsed and/or refractory MM and concomitant renal dysfunction. This article reviews the etiology and incidence of renal adverse events in patients with MM, the renal safety profile of single-agent carfilzomib from four phase II studies in patients with relapsed and/or refractory MM, and the management of patients with MM who receive carfilzomib and are at risk for renal complications.
多发性骨髓瘤（MM）患者常因患者特有风险因素、MM 的病理生理学和治疗相关不良事件而出现肾功能障碍。MM 患者存在肾脏并发症可能与疾病进展有关，是生存的负性预后因素。这些患者常接受剂量减少或调整的治疗方案，这可能导致剂量不足，并可能对治疗效果产生不利影响。因此，需要具有良好肾脏安全性特征的有效治疗方法。卡非佐米是一种选择性蛋白酶体抑制剂，在美国被批准作为单药治疗复发和难治性 MM。安全性研究表明，单药卡非佐米在复发和/或难治性 MM 伴有肾功能障碍的患者中具有良好的耐受性。本文综述了 MM 患者发生肾脏不良事件的病因和发生率、四项复发和/或难治性 MM 患者单药卡非佐米的 II 期研究中的肾脏安全性特征，以及接受卡非佐米治疗且有肾脏并发症风险的 MM 患者的管理。
