IMS 2025 | Managing cardiovascular toxicities associated with carfilzomib in multiple myeloma

So I think when we think about carfilzomib, one thing that really springs to mind is the cardiovascular toxicity because that’s something that can potentially be life-threatening. However, and this should also be basically the bottom line, this is really manageable because we’ve learned a lot more about how to better deal with it and that actually it is not that common to really have significant cardiovascular side effects. What is quite common are hypertension, so high blood pressure, but this usually can be handled. And then what is important before you start the treatment and then also throughout that you are optimally assessed by a cardio-oncologist, so someone who is familiar with both the cardiology aspect and the oncology aspect, but if that’s not available also have a thorough cardiac assessment before with some echocardiography and you know looking at your prior diseases and stuff so that is important for the management. And in a small sub-study from the CONCEPT trial we also looked at biomarkers because actually the data for biomarkers, cardiac biomarkers in the first-line setting is pretty scarce. And there we could show that, for example, an elevated NT-proBNP level is quite common but that this does not predict any cardiovascular events so based on the biomarker alone you should really not withhold this effective treatment option.

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