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Pick up to three peptides to see how their mechanisms, studied uses and evidence levels differ. Rows where the entries disagree are marked with a blue edge.
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Comparison
Carfilzomib
Oncology
Evidence level
Strong evidence
Approval status
Approved drug
Mechanism of action
- 1.Covalently and irreversibly inhibits the chymotrypsin-like site of the proteasome.
- 2.Protein waste builds up in myeloma cells until they die.
- 3.Blocks NF-kappa-B signalling by preventing I-kappa-B breakdown.
- 4.Irreversible binding means the effect lasts until new proteasomes are made.
- 5.Its different chemistry allows activity in some bortezomib-resistant disease.
Studied for
- Relapsed or refractory multiple myeloma (ASPIRE and ENDEAVOR)
- Combination with lenalidomide and dexamethasone
- Combination with daratumumab
- Front-line myeloma in some regimens
Reported effects
- Longer progression-free survival than standard comparator regimens in ASPIRE and ENDEAVOR
- Peripheral neuropathy less frequent than with bortezomib
- Cardiovascular events and hypertension, which require monitoring
- Infusion reactions, mitigated by premedication
Side effects
- Hypertension and heart failure
- Cardiac events including arrhythmia
- Infusion reactions
- Fatigue
- Diarrhoea and nausea
- Thrombocytopenia and anaemia
- Pulmonary hypertension and dyspnoea
Research protocol
Research context only - a specialist cancer medicine. Regimens step from 20 mg per square metre on the first doses to 27 mg per square metre twice weekly, or up to 56 to 70 mg per square metre on a once-weekly schedule, in 28-day cycles with dexamethasone; trials tracked progression-free survival with blood pressure, cardiac and renal monitoring.
Research context only
Evidence justification
Two large randomised phase 3 trials (ASPIRE and ENDEAVOR) with progression-free survival as the primary endpoint, and regulatory approval in the EU and US.