Kyprolis® (carfilzomib) for injection is a type of prescription medicine (a proteasome inhibitor) used to treat patients with multiple myeloma. It is approved for the following:
- In the U.S. and in Europe for the treatment of patients with relapsed or refractory multiple myeloma who have received one to three previous treatments. For these patients, Kyprolis is used combination with Revlimid (lenalidomide) and dexamethasone, or in combination with just dexamethasone.
- In only the U.S. as a single agent (alone) for the treatment of patients with relapsed or refractory MM who have received one or more lines of therapy.
How Does It Work?
Both normal cells and cancer cells contain proteasomes, enzyme complexes that break down damaged and unwanted proteins into smaller components. Proteasomes also carry out the regulated breakdown of undamaged proteins in the cell, a process that is necessary for the control of many critical cellular functions. These smaller components are then used to create new proteins required by the cell. Proteasomes can be thought of as crucial to the cell’s “recycling” of proteins. Kyprolis forms an irreversible bond with the proteasome in the nucleus of each myeloma cell. When Kyprolis inhibits proteasomes, the myeloma cells stop dividing and die.
Possible Side Effects
Fatigue is the most common side effect associated with Kyprolis therapy, one that can appear with increasing severity over time. See the IMF publication, Understanding Fatigue, for further information about this topic and about anemia.
Red blood cells contain hemoglobin, a protein that contains iron and transports oxygen from the lungs to the body’s organs and tissues. When a patient has anemia, the result is low levels of oxygen in the body, which may cause shortness of breath and feelings of exhaustion. As with fatigue, anemia is not an immediate effect of Kyprolis, but one that appears with duration of treatment.
Nausea may occur while taking Kyprolis, but it is usually not severe. If vomiting occurs and leads to dehydration, the patient may experience dizziness, lightheadedness, or fainting. Medical treatment may be required for dehydration.
Thrombocytopenia (decreased platelet levels)
Patients taking Kyprolis often experience thrombocytopenia – a lowered level of platelets in the blood. Platelets help blood to clot after an injury; fewer platelets can lead to bruising, bleeding, and slower healing. Kyprolis causes the platelet count to drop, but the required interval between doses allows time for the platelet count to return to the baseline level by the beginning of the next cycle.
Dyspnea (shortness of breath)
Shortness of breath can result from many causes, including heart and/or lung problems, anemia, deconditioning (lack of exercise), and obesity. If there is a sudden change in your breathing, it is especially important that you contact your doctor right away. There have been reports of heart and lung disorders in patients receiving Kyprolis, so shortness of breath can be a sign of a serious problem, and should be reported to your healthcare providers promptly.
Diarrhea may occur while taking Kyprolis. Dizziness, lightheadedness, or fainting may occur due to dehydration caused by either excessive or persistent diarrhea.
Fever can signal bacterial or viral infection, an adverse reaction to a drug, or in rare cases, an aggressive multiple myeloma relapse. Since fever could be the sign of a life-threatening condition, you should report this problem immediately. The combination of fever and shortness of breath is of special concern. If this occurs, the patient must have immediate treatment.
Other side effects
Other side effects can occur with Kyprolis, but they are much less frequent. These side effects include heart problems, tumor lysis syndrome (TLS), lung disorders, and liver problems. You will be monitored carefully during treatment for any signs of these problems. If you have questions or concerns about any of these potential issues, you should discuss them with your treating physician.
Official drug manufacturer's website for Kyprolis (carfilzomib).
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