The phase 3 A.R.R.O.W. study demonstrated that treatment with once-weekly carfilzomib (70 mg/m²) and dexamethasone (once-weekly Kd70 mg/m²) improved progression-free survival compared with twice-weekly carfilzomib (27 mg/m²) and dexamethasone (twice-weekly Kd27 mg/m²) in patients with relapsed and refractory multiple myeloma (RRMM; median, 11.2 versus 7.6 months; hazard ratio [HR] = 0.69; 95% confidence interval, 0.54–0.88; P = 0.0029). Once-weekly dosing also improved response rates and depth of response. We performed a subgroup analysis from A.R.R.O.W. according to age (<65, 65–74, or ≥75 years), renal function (creatinine clearance <50, ≥50–<80, or ≥80 mL/min), number of prior therapies (2 or 3), and bortezomib-refractory status (yes or no). Compared with twice-weekly Kd27 mg/m², once-weekly Kd70 mg/m² reduced the risk of progression or death (HR = 0.60–0.85) and increased overall response rates in nearly all the examined subgroups, consistent with reports in the overall A.R.R.O.W. population. The safety profiles of once-weekly Kd70 mg/m² across subgroups were also generally consistent with those in the overall population. Findings from this subgroup analysis generally demonstrate a favorable benefit–risk profile of once-weekly Kd70 mg/m², further supporting once-weekly carfilzomib dosing as an appropriate treatment option for patients with RRMM, regardless of baseline patient and disease characteristics.

3 期 ARROW 研究表明，与每周两次卡非佐米 (27 mg/m ² ) 相比，每周一次卡非佐米 (70 mg/m 2 )和地塞米松 (每周一次 Kd70 mg/m ^{2 )}治疗可改善无进展生存期和地塞米松（每周两次 Kd27 mg/m ²）治疗复发难治性多发性骨髓瘤患者（RRMM；中位时间，11.2 个月与 7.6 个月；风险比 [HR] = 0.69；95% 置信区间，0.54–0.88；P =  0.0029 ）。每周一次给药还可以提高反应率和反应深度。我们根据年龄（<65、65-74 或 ≥75 岁）、肾功能（肌酐清除率 <50、≥50-<80 或 ≥80 mL/min）、既往治疗次数从 ARROW 进行亚组分析（2 或 3），以及硼替佐米难治性状态（是或否）。与每周两次 Kd27 mg/m ²相比，每周一次 Kd70 mg/m ²降低了疾病进展或死亡的风险（HR = 0.60–0.85），并提高了几乎所有检查亚组的总体缓解率，这与ARROW 总体人口。各亚组每周一次 Kd70 mg/m ²的安全性也与总体人群的安全性基本一致。该亚组分析的结果通常表明每周一次 Kd70 mg/m ²具有良好的效益-风险特征，进一步支持每周一次卡非佐米给药作为 RRMM 患者的适当治疗选择，无论患者基线和疾病特征如何。