THOUSAND OAKS, Calif.,
Dec. 11, 2017 /PRNewswire/
-- Amgen (NASDAQ: AMGN) today announced new results showing
the positive overall survival (OS) findings from the final analysis
of the Phase 3 ASPIRE trial. The study met the key secondary
endpoint of OS, demonstrating that the addition of
KYPROLIS® (carfilzomib) to lenalidomide and
dexamethasone (KRd) reduced the risk of death by 21 percent versus
lenalidomide and dexamethasone alone (Rd) and extended survival by
7.9 months in patients with relapsed or refractory multiple myeloma
(median OS 48.3 months for KRd versus 40.4 months for Rd, HR =
0.79, 95 percent CI, 0.67 – 0.95; p = 0.0045). These results
were presented today during an oral presentation at the
59th American Society of Hematology (ASH) Annual Meeting
& Exposition in Atlanta (ASH
abstract #743).
"While significant advances have recently been made in treating
relapsed or refractory multiple myeloma, most reported clinical
trials have focused on how long a new treatment helps prevent
recurrence of disease rather than on survival," said Keith Stewart, M.B., Ch.B., Mayo Clinic in
Arizona and principal investigator
of the ASPIRE trial. "Results from the ASPIRE trial are among the
first to show a significant overall survival advantage
resulting from adding carfilzomib to lenalidomide and dexamethasone
treatment in patients with relapsed or refractory multiple
myeloma. The data support the early use of carfilzomib as an
effective therapy at first relapse, regardless of prior treatment
with Velcade or transplant."
"KYPROLIS-based regimens are the first and only to demonstrate
superior overall survival versus today's standard of care in two
Phase 3 studies and are resetting survival expectations for
relapsed or refractory multiple myeloma patients," said
David Reese, M.D., senior vice
president of Translational Sciences and Oncology at Amgen. "We are
pleased with the KYPROLIS overall survival data presented at ASH
this year as the results underscore our commitment to developing
innovative treatment options to help cancer patients live
longer."
The final analysis of ASPIRE included subgroup analyses by prior
lines of therapy, prior Velcade exposure at first relapse, and
prior transplant at first relapse. Among these three groups, there
was an 18 to 29 percent reduction in the risk of death for KRd
versus Rd, consistent with findings in the overall population.
Median OS was 11.4 months longer for KRd versus Rd in patients who
had received one prior line of therapy (47.3 versus 35.9 months [HR
= 0.81, 95 percent CI, 0.62 – 1.06]) and 6.5 months longer for
patients with two or more prior lines (48.8 versus 42.3 months [HR
= 0.79, 95 percent CI, 0.62 – 0.99]).
Notably the maximum OS improvement of 11 months was observed for
patients at first relapse. This OS analysis supports the early use
of KYPROLIS as effective therapy at first relapse, regardless of
prior Velcade exposure or transplant. Patients treated with KRd
reported improved global health status, with higher Global Health
Status/Quality of Life (QoL) scores compared with Rd over 18 cycles
of treatment (1‑sided p‑value = 0.0001) measured
with the EORTC QLQ‑C30, an instrument validated in multiple
myeloma.
Overall survival by Revised International Staging System (R-ISS)
stage was also assessed. For R-ISS stage I (KRd, n = 42; Rd, n =
46), median OS was not reached for KRd and was 58 months for Rd (HR
= 0.49, 95 percent CI, 0.26 – 0.92). For patients with R-ISS stage
II (KRd, n = 194; Rd, n = 195), median OS was 45.4 months for KRd
and 41.2 months for Rd (4.2 months; HR = 0.86, 95 percent CI, 0.68
– 1.10). For the small number of patients with R-ISS stage III
(KRd, n = 37; Rd, n = 47), median OS was 23.3 months for KRd and
18.8 months for Rd (4.5 months; HR = 1.05, 95 percent CI, 0.66 –
1.68).
The safety data from ASPIRE was consistent with the known safety
profile of KYPROLIS. The most common adverse events (greater than
or equal to 20 percent) in the KYPROLIS arm were diarrhea, anemia,
neutropenia, fatigue, upper respiratory tract infection, pyrexia,
cough, hypokalemia, thrombocytopenia, muscle spasms, pneumonia,
nasopharyngitis, nausea, constipation, insomnia and
bronchitis.
Overall survival results from the Phase 3 ENDEAVOR head-to-head
study of KYPROLIS plus dexamethasone (Kd) versus Velcade plus
dexamethasone were also presented at ASH and showed that Kd was
superior in extending survival across a variety of sub-group
analyses of relapsed or refractory multiple myeloma patients,
including age, prior line of therapy and previous exposure to
Velcade (ASH abstract #1885, ASH abstract #1850).
The KRd and Kd regimens used in these trials are currently
approved in the U.S., European Union and other countries based on
primary analyses of progression-free survival (PFS) in the ASPIRE
and ENDEAVOR studies, respectively. The KYPROLIS dosing used for
ASPIRE (27 mg/m2; 10-minute infusion) and ENDEAVOR (56
mg/m2; 30-minute infusion) were optimized for each
treatment regimen and are the currently approved doses for the KRd
and Kd regimens, respectively.1
Based on the ASPIRE results, Amgen has submitted a supplemental
New Drug Application to the U.S. Food and Drug Administration to
include the OS data from ASPIRE in the product information for
KYPROLIS.
About ASPIRE
The international, randomized Phase 3
ASPIRE (CArfilzomib, Lenalidomide, and DexamethaSone
versus Lenalidomide and Dexamethasone for the treatment
of PatIents with Relapsed Multiple
MyEloma) trial evaluated KYPROLIS in combination with
lenalidomide and dexamethasone, versus lenalidomide and
dexamethasone alone, in patients with relapsed or refractory
multiple myeloma following treatment with one to three prior
regimens. The primary endpoint of the trial was PFS, defined as the
time from treatment initiation to disease progression or death.
Secondary endpoints included OS, overall response rate, duration of
response, disease control rate, health-related quality of life and
safety. Patients were randomized to receive KYPROLIS (20
mg/m2 on days 1 and 2 of cycle one, escalating to
27 mg/m2 on days 8, 9, 15 and 16 of cycle one and
continuing on days 1, 2, 8, 9, 15 and 16 of subsequent cycles), in
addition to a standard dosing schedule of lenalidomide (25 mg per
day for 21 days on, 7 days off) and low-dose dexamethasone (40 mg
per week in four-week cycles), versus lenalidomide and low-dose
dexamethasone alone. The study randomized 792 patients at sites
in North America, Europe and Israel.
For the overall study population, treatment discontinuation due
to an adverse event occurred in 19.9 percent of patients treated
with KRd and 21 percent of patients receiving Rd. Fatal adverse
events were reported in 11.5 percent of KRd-treated patients and
10.5 percent of patients treated with Rd. Grade ≥3 adverse event
rates were 87 percent for KRd and 83 percent for Rd. Selected grade
≥3 adverse events of interest (grouped terms; KRd vs Rd) included
acute renal failure (3.8 percent versus 3.3 percent), cardiac
failure (4.3 percent versus 2.1 percent), ischemic heart disease
(3.8 percent versus 2.3 percent), hypertension (6.4 percent versus
2.3 percent), and hematopoietic thrombocytopenia (20.2 percent
versus 14.9 percent).
About ENDEAVOR
The randomized ENDEAVOR
(RandomizEd, OpeN Label, Phase 3 Study of
Carfilzomib Plus DExamethAsone Vs
Bortezomib Plus DexamethasOne in Patients
With Relapsed Multiple Myeloma) trial of 929 patients
evaluated KYPROLIS in combination with low-dose dexamethasone,
versus Velcade with low-dose dexamethasone in relapsed or
refractory patients who previously received at least one, but not
more than three prior therapeutic regimens. The primary endpoint of
the trial was PFS, defined as the time from treatment initiation to
disease progression or death. The primary analysis was published
in The Lancet Oncology and is described in the
Prescribing Information.
Patients received treatment until progression with KYPROLIS as a
30-minute infusion on days 1, 2, 8, 9, 15 and 16 of 28 day
treatment cycles, along with low-dose dexamethasone (20 mg). For
cycle one only, KYPROLIS was administered at 20
mg/m2 on days 1 and 2, and if tolerated was
escalated to 56 mg/m2 from day 8 cycle one
onwards. Patients who received Velcade (1.3 mg/m2) with
low-dose dexamethasone (20 mg) were treated with Velcade
administered subcutaneously or intravenously at the discretion of
the investigator and in accordance with regional regulatory
approval of Velcade. More than 75 percent of the patients in the
control arm received Velcade subcutaneously. This study was
conducted at 235 sites worldwide. For information about this trial,
please visit www.clinicaltrials.gov under trial
identification number NCT01568866.
About Multiple Myeloma
Multiple myeloma is an
incurable blood cancer, characterized by a recurring pattern of
remission and relapse.2 It is a rare and
life-threatening disease that accounts for approximately one
percent of all cancers. 3,4 Worldwide, approximately
114,000 people are diagnosed with multiple myeloma each year and
80,000 patient deaths are reported on an annual
basis.3
About
KYPROLIS® (carfilzomib)
Proteasomes
play an important role in cell function and growth by breaking down
proteins that are damaged or no longer
needed.5 KYPROLIS has been shown to block
proteasomes, leading to an excessive build-up of proteins within
cells.5 In some cells, KYPROLIS can cause cell
death, especially in myeloma cells because they are more likely to
contain a higher amount of abnormal proteins. 5,6
KYPROLIS is approved in the U.S. for the following:
- In combination with dexamethasone or with lenalidomide plus
dexamethasone for the treatment of patients with relapsed or
refractory multiple myeloma who have received one to three lines of
therapy.
- As a single agent for the treatment of patients with relapsed
or refractory multiple myeloma who have received one or more lines
of therapy.
KYPROLIS is also approved in Argentina, Australia, Bahrain, Canada, Hong
Kong, Israel, Japan, Kuwait, Lebanon, Macao, Mexico, Thailand, Colombia, S. Korea, Canada, Qatar, Switzerland, United
Arab Emirates, Turkey,
Russia, Brazil, India, Oman
and the European Union. Additional regulatory applications for
KYPROLIS are underway and have been submitted to health authorities
worldwide.
IMPORTANT SAFETY INFORMATION
Cardiac Toxicities
- New onset or worsening of pre-existing cardiac failure (e.g.,
congestive heart failure, pulmonary edema, decreased ejection
fraction), restrictive cardiomyopathy, myocardial ischemia, and
myocardial infarction including fatalities have occurred following
administration of KYPROLIS. Some events occurred in patients with
normal baseline ventricular function. Death due to cardiac arrest
has occurred within one day of KYPROLIS administration.
- Monitor patients for clinical signs or symptoms of cardiac
failure or cardiac ischemia. Evaluate promptly if cardiac toxicity
is suspected. Withhold KYPROLIS for Grade 3 or 4 cardiac adverse
events until recovery, and consider whether to restart KYPROLIS at
1 dose level reduction based on a benefit/risk assessment.
- While adequate hydration is required prior to each dose in
Cycle 1, monitor all patients for evidence of volume overload,
especially patients at risk for cardiac failure. Adjust total fluid
intake as clinically appropriate in patients with baseline cardiac
failure or who are at risk for cardiac failure.
- Patients ≥ 75 years, the risk of cardiac failure is increased.
Patients with New York Heart Association Class III and IV heart
failure, recent myocardial infarction, conduction abnormalities,
angina, or arrhythmias may be at greater risk for cardiac
complications and should have a comprehensive medical assessment
(including blood pressure and fluid management) prior to starting
treatment with KYPROLIS and remain under close follow-up.
Acute Renal Failure
- Cases of acute renal failure and renal insufficiency adverse
events (including renal failure) have occurred in patients
receiving KYPROLIS. Acute renal failure was reported more
frequently in patients with advanced relapsed and refractory
multiple myeloma who received KYPROLIS monotherapy. Monitor renal
function with regular measurement of the serum creatinine and/or
estimated creatinine clearance. Reduce or withhold dose as
appropriate.
Tumor Lysis Syndrome
- Cases of Tumor Lysis Syndrome (TLS), including fatal outcomes,
have occurred in patients receiving KYPROLIS. Patients with
multiple myeloma and a high tumor burden should be considered at
greater risk for TLS. Adequate hydration is required prior to each
dose in Cycle 1, and in subsequent cycles as needed. Consider uric
acid lowering drugs in patients at risk for TLS. Monitor for
evidence of TLS during treatment and manage promptly. Withhold
KYPROLIS until TLS is resolved.
Pulmonary Toxicity
- Acute Respiratory Distress Syndrome (ARDS), acute respiratory
failure, and acute diffuse infiltrative pulmonary disease such as
pneumonitis and interstitial lung disease have occurred in patients
receiving KYPROLIS. Some events have been fatal. In the event of
drug-induced pulmonary toxicity, discontinue KYPROLIS.
Pulmonary Hypertension
- Pulmonary arterial hypertension (PAH) was reported in patients
treated with KYPROLIS. Evaluate with cardiac imaging and/or other
tests as indicated. Withhold KYPROLIS for PAH until resolved or
returned to baseline and consider whether to restart KYPROLIS based
on a benefit/risk assessment.
Dyspnea
- Dyspnea was reported in patients treated with KYPROLIS.
Evaluate dyspnea to exclude cardiopulmonary conditions including
cardiac failure and pulmonary syndromes. Stop KYPROLIS for Grade 3
or 4 dyspnea until resolved or returned to baseline. Consider
whether to restart KYPROLIS based on a benefit/risk
assessment.
Hypertension
- Hypertension, including hypertensive crisis and hypertensive
emergency, has been observed with KYPROLIS. Some of these events
have been fatal. Monitor blood pressure regularly in all patients.
If hypertension cannot be adequately controlled, withhold KYPROLIS
and evaluate. Consider whether to restart KYPROLIS based on a
benefit/risk assessment.
Venous Thrombosis
- Venous thromboembolic events (including deep venous thrombosis
and pulmonary embolism) have been observed with KYPROLIS.
Thromboprophylaxis is recommended for patients being treated with
the combination of KYPROLIS with dexamethasone or with lenalidomide
plus dexamethasone. The thromboprophylaxis regimen should be based
on an assessment of the patient's underlying risks.
- Patients using oral contraceptives or a hormonal method of
contraception associated with a risk of thrombosis should consider
an alternative method of effective contraception during treatment
with KYPROLIS in combination with dexamethasone or lenalidomide
plus dexamethasone.
Infusion Reactions
- Infusion reactions, including life-threatening reactions, have
occurred in patients receiving KYPROLIS.
- Symptoms include fever, chills, arthralgia, myalgia, facial
flushing, facial edema, vomiting, weakness, shortness of breath,
hypotension, syncope, chest tightness, or angina. These reactions
can occur immediately following or up to 24 hours after
administration of KYPROLIS. Premedicate with dexamethasone to
reduce the incidence and severity of infusion reactions. Inform
patients of the risk and of symptoms of an infusion reaction and to
contact a physician immediately if they occur.
Hemorrhage
- Fatal or serious cases of hemorrhage have been reported in
patients receiving KYPROLIS. Hemorrhagic events have included
gastrointestinal, pulmonary, and intracranial hemorrhage and
epistaxis. Promptly evaluate signs and symptoms of blood loss.
Reduce or withhold dose as appropriate.
Thrombocytopenia
- KYPROLIS causes thrombocytopenia with recovery to baseline
platelet count usually by the start of the next cycle.
Thrombocytopenia was reported in patients receiving KYPROLIS.
Monitor platelet counts frequently during treatment with KYPROLIS.
Reduce or withhold dose as appropriate.
Hepatic Toxicity and Hepatic Failure
- Cases of hepatic failure, including fatal cases, have been
reported during treatment with KYPROLIS. KYPROLIS can cause
increased serum transaminases. Monitor liver enzymes regularly
regardless of baseline values. Reduce or withhold dose as
appropriate.
Thrombotic Microangiopathy
- Cases of thrombotic microangiopathy, including thrombotic
thrombocytopenic purpura/hemolytic uremic syndrome (TTP/HUS),
including fatal outcome have occurred in patients receiving
KYPROLIS. Monitor for signs and symptoms of TTP/HUS. Discontinue
KYPROLIS if diagnosis is suspected. If the diagnosis of TTP/HUS is
excluded, KYPROLIS may be restarted. The safety of reinitiating
KYPROLIS therapy in patients previously experiencing TTP/HUS is not
known.
Posterior Reversible Encephalopathy Syndrome (PRES)
- Cases of PRES have occurred in patients receiving KYPROLIS.
PRES was formerly known as Reversible Posterior Leukoencephalopathy
Syndrome. Consider a neuro-radiological imaging (MRI) for onset of
visual or neurological symptoms. Discontinue KYPROLIS if PRES is
suspected and evaluate. The safety of reinitiating KYPROLIS therapy
in patients previously experiencing PRES is not known.
Increased Fatal and Serious Toxicities in Combination with
Melphalan and Prednisone in Newly Diagnosed
Transplant‐ineligible Patients
- In a clinical trial of transplant‐ineligible patients with
newly diagnosed multiple myeloma comparing KYPROLIS, melphalan, and
prednisone (KMP) vs bortezomib, melphalan, and prednisone (VMP), a
higher incidence of serious and fatal adverse events was observed
in patients in the KMP arm. KYPROLIS in combination with
melphalan and prednisone is not indicated for transplant‐ineligible
patients with newly diagnosed multiple myeloma.
Embryo-fetal Toxicity
- KYPROLIS can cause fetal harm when administered to a pregnant
woman based on its mechanism of action and findings in
animals.
- Females of reproductive potential should be advised to avoid
becoming pregnant while being treated with KYPROLIS. Males of
reproductive potential should be advised to avoid fathering a child
while being treated with KYPROLIS. If this drug is used during
pregnancy, or if pregnancy occurs while taking this drug, the
patient should be apprised of the potential hazard to the
fetus.
ADVERSE REACTIONS
- The most common adverse reactions occurring in at least 20% of
patients treated with KYPROLIS in the combination therapy trials:
anemia, neutropenia, diarrhea, dyspnea, fatigue, thrombocytopenia,
pyrexia, insomnia, muscle spasm, cough, upper respiratory tract
infection, hypokalemia.
- The most common adverse reactions occurring in at least 20% of
patients treated with KYPROLIS in monotherapy trials: anemia,
fatigue, thrombocytopenia, nausea, pyrexia, dyspnea, diarrhea,
headache, cough, edema peripheral.
Please see full prescribing information
at www.kyprolis.com.
About Amgen's Commitment to Oncology
Amgen Oncology is
committed to helping patients take on some of the toughest cancers,
such as those that have been resistant to drugs, those that
progress rapidly through the body and those where limited treatment
options exist. Amgen's supportive care treatments help patients
combat certain side effects of strong chemotherapy, and our
targeted medicines and immunotherapies focus on more than a dozen
different malignancies, ranging from blood cancers to solid tumors.
With decades of experience providing therapies for cancer patients,
Amgen continues to grow its portfolio of innovative and biosimilar
oncology medicines.
About Amgen
Amgen is committed to unlocking
the potential of biology for patients suffering from serious
illnesses by discovering, developing, manufacturing and delivering
innovative human therapeutics. This approach begins by using tools
like advanced human genetics to unravel the complexities of disease
and understand the fundamentals of human biology.
Amgen focuses on areas of high unmet medical need and
leverages its expertise to strive for solutions that improve health
outcomes and dramatically improve people's lives. A biotechnology
pioneer since 1980, Amgen has grown to be one of the
world's leading independent biotechnology companies, has reached
millions of patients around the world and is developing a pipeline
of medicines with breakaway potential.
For more information, visit www.amgen.com and follow
us on www.twitter.com/amgen.
Forward-Looking Statements
This news release
contains forward-looking statements that are based on the current
expectations and beliefs of Amgen. All statements, other than
statements of historical fact, are statements that could be deemed
forward-looking statements, including estimates of revenues,
operating margins, capital expenditures, cash, other financial
metrics, expected legal, arbitration, political, regulatory or
clinical results or practices, customer and prescriber patterns or
practices, reimbursement activities and outcomes and other such
estimates and results. Forward-looking statements involve
significant risks and uncertainties, including those discussed
below and more fully described in the Securities and Exchange
Commission reports filed by Amgen, including our most
recent annual report on Form 10-K and any subsequent periodic
reports on Form 10-Q and Form 8-K. Unless otherwise
noted, Amgen is providing this information as of the date
of this news release and does not undertake any obligation to
update any forward-looking statements contained in this document as
a result of new information, future events or otherwise.
No forward-looking statement can be guaranteed and actual
results may differ materially from those we project. Discovery or
identification of new product candidates or development of new
indications for existing products cannot be guaranteed and movement
from concept to product is uncertain; consequently, there can be no
guarantee that any particular product candidate or development of a
new indication for an existing product will be successful and
become a commercial product. Further, preclinical results do not
guarantee safe and effective performance of product candidates in
humans. The complexity of the human body cannot be perfectly, or
sometimes, even adequately modeled by computer or cell culture
systems or animal models. The length of time that it takes for us
to complete clinical trials and obtain regulatory approval for
product marketing has in the past varied and we expect similar
variability in the future. Even when clinical trials are
successful, regulatory authorities may question the sufficiency for
approval of the trial endpoints we have selected. We develop
product candidates internally and through licensing collaborations,
partnerships and joint ventures. Product candidates that are
derived from relationships may be subject to disputes between the
parties or may prove to be not as effective or as safe as we may
have believed at the time of entering into such relationship. Also,
we or others could identify safety, side effects or manufacturing
problems with our products, including our devices, after they are
on the market.
Our results may be affected by our ability to successfully
market both new and existing products domestically and
internationally, clinical and regulatory developments involving
current and future products, sales growth of recently launched
products, competition from other products including biosimilars,
difficulties or delays in manufacturing our products and global
economic conditions. In addition, sales of our products are
affected by pricing pressure, political and public scrutiny and
reimbursement policies imposed by third-party payers, including
governments, private insurance plans and managed care providers and
may be affected by regulatory, clinical and guideline developments
and domestic and international trends toward managed care and
healthcare cost containment. Furthermore, our research, testing,
pricing, marketing and other operations are subject to extensive
regulation by domestic and foreign government regulatory
authorities. Our business may be impacted by government
investigations, litigation and product liability claims. In
addition, our business may be impacted by the adoption of new tax
legislation or exposure to additional tax liabilities. If we fail
to meet the compliance obligations in the corporate integrity
agreement between us and the U.S. government, we could become
subject to significant sanctions. Further, while we routinely
obtain patents for our products and technology, the protection
offered by our patents and patent applications may be challenged,
invalidated or circumvented by our competitors, or we may fail to
prevail in present and future intellectual property litigation. We
perform a substantial amount of our commercial manufacturing
activities at a few key manufacturing facilities, including in
Puerto Rico, and also depend on
third parties for a portion of our manufacturing activities, and
limits on supply may constrain sales of certain of our current
products and product candidate development. In addition, we compete
with other companies with respect to many of our marketed products
as well as for the discovery and development of new products.
Further, some raw materials, medical devices and component parts
for our products are supplied by sole third-party suppliers.
Certain of our distributors, customers and payers have substantial
purchasing leverage in their dealings with us. The discovery of
significant problems with a product similar to one of our products
that implicate an entire class of products could have a material
adverse effect on sales of the affected products and on our
business and results of operations. Our efforts to acquire other
companies or products and to integrate the operations of companies
we have acquired may not be successful. We may not be able to
access the capital and credit markets on terms that are favorable
to us, or at all. We are increasingly dependent on information
technology systems, infrastructure and data security. Our stock
price is volatile and may be affected by a number of events. Our
business performance could affect or limit the ability of our Board
of Directors to declare a dividend or our ability to pay a dividend
or repurchase our common stock.
CONTACT: Amgen, Thousand
Oaks
Kristen Davis, 805-447-3008
(Media)
Kristen Neese, 805-313-8267
(Media)
Arvind Sood, 805-447-1060
(Investors)
References
- Jakubowiak A. Evolution of Carfilzomib Dose and Schedule in
Patients With Multiple Myeloma: A Historical Overview. Cancer
Treatment Review. 2014; 40(6):781-790.
- Jakubowiak A. Management Strategies for Relapsed/Refractory
Multiple Myeloma: Current Clinical Perspectives. Seminars
in Hematology. 2012; 49(3)(1),S16-S32.
- GLOBOCAN 2012. Global Prevalence and Incidence. Available at:
http://globocan.iarc.fr/old/summary_table_pop_prev.asp?selection=224900&title=World&sex=0&window=1&sort=0&submit=%C2%A0Execute%C2%A0http://globocan.iarc.fr/old/summary_table_pop_prev.asp?selection=224900&title=World&sex=0&window=1&sort=0&submit=%C2%A0Execute%C2%A0.
Accessed on Nov. 3, 2017.
- American Cancer Society. About Multiple Myeloma. Available at
https://www.cancer.org/content/dam/CRC/PDF/Public/8738.00.pdf.
Accessed on Nov. 3, 2017.
- Moreau P, Richardson PG, Cavo M, et al. Proteasome Inhibitors
in Multiple Myeloma: 10 Years Later. Blood. 2012;
120(5):947-959.
- Kortuem KM and Stewart AK. Carfilzomib. Blood. 2012;
121(6):893-897.
SOURCE Amgen