New combination treatment improves multiple myeloma outcomes

The University of Cincinnati Cancer Center's Ed Faber, DO, provided commentary to Medscape on the COBRA study that found the combination of carfilzomib combined with lenalidomide and dexamethasone (KRd) shows significantly greater efficacy than the previous standard of care.

The study was presented at the American Society of Hematology (ASH) 2025 Annual Meeting by first author Dominik Dytfeld, MD, of Poznan University of Medical Sciences, Poznan, Poland.

Patients were randomized in the trial to receive KRd or lenalidomide and dexamethasone combined with bortezomib (VRd).

Patients treated with the KRd regimen had a 43% greater reduction in the risk of death or disease progression at a median follow-up of 53 months.

Faber, associate professor in UC's College of Medicine, director of the Adult BMT & Cellular Therapy Program and Hematology Disease Leader at the University of Cincinnati Cancer Center, was an author of the previous ENDURANCE trial that COBRA builds on.

“What we learned from ENDURANCE is that complete response and very good partial response favored KRd versus VRd; however, the toxicity profile abrogated this benefit, thus [progression free survival] and [overall survival] were similar,” Faber told Medscape.

“The current study supports similar conclusions — grade 3 adverse effects more for KRd than VRd and higher cardiac side effects,” he continued. “Of course, neuropathy was much higher, but that is well known for VRd and consistent.”

Read the Medscape article.

Featured photo at top of Ed Faber speaking with a patient. Photo/UC Health.