Dimopoulos MA et al. - Based on the current study, carfilzomib was shown to be the only multiple myeloma treatment that extends overall survival in the relapsed setting over the current standard of care.

Methods
929 patients with relapsed or refractory multiple myeloma who had received 1-3 lines of therapy were recruited from 198 hospitals in 28 countries (ENDEAVOR).
Patients were randomly assigned to receive carfilzomib and dexamethasone (carfilzomib group; n=464) or bortezomib and dexamethasone (bortezomib group; n=465).
Carfilzomib (20 mg/m2 on days 1 and 2 of cycle 1; 56 mg/m2 thereafter) was given as a 30-min intravenous infusion on days 1, 2, 8, 9, 15, and 16 of 28-day cycles; bortezomib (1·3 mg/m2) was given as an intravenous bolus or subcutaneous injection on days 1, 4, 8, and 11 of 21-day cycles. Dexamethasone (20 mg oral or intravenous infusion) was given on days 1, 2, 8, 9, 15, 16, 22, and 23 in the carfilzomib group and on days 1, 2, 4, 5, 8, 9, 11, and 12 in the bortezomib group.

Results
The median overall survival was 47.6 months in the carfilzomib group versus 40.0 months in the bortezomib group (HR = 0.791).
Grade 3 or worse adverse events were reported in 377 of 463 patients in the carfilzomib group and 324 of 456 patients in the bortezomib group.
Serious adverse events occurred in 273 patients in the carfilzomib group and 182 patients in the bortezomib group.