Carfilzomib
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
| ID | DRUG-CARFILZOMIB |
|---|---|
| Type | Drug |
| Aliases | KyprolisКарфілзоміб |
| Status | reviewed 2026-04-25 | pending_clinical_signoff |
| Diseases | DIS-MM DIS-WM |
| Sources | SRC-ESMO-MM-2023 SRC-NCCN-MM-2025 |
Drug Facts
| Class | Second-generation irreversible proteasome inhibitor (epoxyketone) |
|---|---|
| Mechanism | Selective irreversible inhibitor of the chymotrypsin-like activity of the 20S proteasome (β5 / LMP7 subunits). Binds covalently via epoxyketone — distinct from bortezomib's reversible boronate binding — conferring sustained inhibition + activity in bortezomib-refractory myeloma. Single doses can suppress proteasome activity >80% for >24h. |
| Typical dosing | Multiple schedules. KRd: 27 mg/m² days 1, 2, 8, 9, 15, 16 of 28-day cycle (escalated from 20 mg/m² day 1, 2 of cycle 1). KdW (weekly, CHAMPION-1 / ARROW): 70 mg/m² IV days 1, 8, 15 of 28-day cycle. Hydration 250-500 mL pre + post infusion mandatory. |
| Ukraine registered | True |
| NSZU reimbursed | True |
| Ukraine last verified | 2026-04-27 |
Notes
Cardiac toxicity is THE safety signal — baseline ECG + ECHO mandatory; blood pressure control critical (target <140/90 pre-dose); hydration protocol non-negotiable for first 2 cycles. ENDEAVOR / ASPIRE / CANDOR trials demonstrate superior PFS over bortezomib-based regimens but at the cost of higher cardiac AEs. Particularly active in early-relapse / early-PI-exposed setting. Weekly schedule (70 mg/m²) is now preferred over twice-weekly for tolerability without efficacy loss (ARROW trial).
Used By
Regimens
REG-CARFILZOMIB-WM- Carfilzomib + Rituximab + Dexamethasone (CaRD) × 6 cycles — for CXCR4-WHIM-mutated WM (BT...REG-DKD- Daratumumab + Carfilzomib + Dexamethasone (DKd / D-Kd / Isa-Kd analog), 28-day cyclesREG-ISA-KD-MM-3L- Isatuximab + Carfilzomib + Dexamethasone (Isa-Kd), 28-day cycles