Proteasome inhibitor-based therapy for treatment of newly diagnosed multiple myeloma.

Multiple myeloma is a hematologic malignancy that is unable to be cured and has significant impact throughout the world. Front line treatment has shifted but ultimately has landed on a bortezomib-based combination therapy. Carfilzomib is a next-generation proteasome inhibitor shown to improve both progression-free and overall survival in relapsed and refractory multiple myeloma in combination with lenalidomide and dexamethasone (KRd). Given the favorable response rates seen in phase II trials treating newly diagnosed myeloma, this combination is listed as a viable option for upfront treatment. This systematic review compares pharmacologic properties, clinical efficacy, and toxicities of carfilzomib- and bortezomib-based regimens.