Carfilzomib versus bortezomib: no longer an ENDEAVOR
Mené dans 27 pays sur 929 patients atteints d'un myélome multiple réfractaire ou récidivant, cet essai de phase III compare l'efficacité, du point de vue de la survie globale, et la toxicité du carfilzomib et du bortézomib, des inhibiteurs du protéasome, en combinaison avec la dexaméthasone
Carfilzomib is an irreversible, epoxyketone proteasome inhibitor, whereas bortezomib is a reversible, boronic acid-based proteasome inhibitor. The randomised phase 3 ENDEAVOR study directly compared carfilzomib (56 mg/m2) plus dexamethasone with bortezomib (1·3 mg/m2) plus dexamethasone in patients with relapsed or refractory multiple myeloma who had received between one and three previous therapies. The first pre-specified interim analysis showed that patients in the carfilzomib group had higher rates of deeper responses, which translated into significantly longer progression-free survival than those who received bortezomib (median progression-free survival 18·7 months [95% CI 15·6–not estimable] vs 9·4 months [8·4–10·4], hazard ratio [HR] 0·53 [95% CI 0·44–0·65]; p<0·0001).
The Lancet Oncology 2017