How it Works

Kyprolis (Carfilzomib) works by inhibiting proteasomes. These proteasomes are necessary for many critical cellular functions (growth, division, and survival). When Kyprolis (Carfilzomib) inhibits proteasome function, the normal balance within a cell is disrupted, the myeloma cells stop digesting proteins (leading to a large protein buildup, which becomes toxic for the cell), halting the cell division and chemical production that stimulate other myeloma cells, resulting in the myeloma cells’ death.

It is important to mention that myeloma cells are more sensitive to these effects than normal cells, so myeloma cells die while normal cells can recover.

How it’s Administered

Kyprolis (Carfilzomib) is administered through an intravenous infusion (IV):

20/27 mg/m2 twice weekly (10 minutes infusion). This infusion can be Kyprolis alone or in combination with Lenalidomide and Dexamethasone (KRd).
20/56 mg/m2 once weekly or 20/70 mg/m2 once weekly (30 minutes infusion). This infusion can be given in the following combinations:
- Kyprolis (Carfilzomib) and Dexamethasone (Kd regimen),
- Kyprolis (Carfilzomib), Darzalex (Daratumumab) and Dexamethasone (DKd regimen), or
- Kyprolis (Carfilzomib), Darzalex Faspro (The subcutaneous version of Daratumumab with hyaluronidase-fihj, which mimics hyaluronidase, a naturally occurring substance that increases the permeability of subcutaneous tissue) and Dexamethasone (DKd regimen).

Who Should Take Kyprolis

Kyprolis is approved for the treatment of adult patients with relapsed or refractory multiple

myeloma as a single agent if the patient has received one or more lines of therapy, or in any of the following combinations if the patient has received one to three lines of therapy:

Revlimid (Lenalidomide) and dexamethasone; or
Dexamethasone; or
Darzalex (Daratumumab) and Dexamethasone; or
Darzalex Faspro (Daratumumab with hyaluronidase-fihj) and Dexamethasone

Who Shouldn’t Take Kyprolis

You should not receive Kyprolis if you are allergic to Kyprolis or if you are pregnant or breastfeeding. Kyprolis should be withheld and evaluated in case of confirmed cardiac, pulmonary, or hepatic pre-existing conditions.

The Most Common Side Effects of Taking Kyprolis Include:

Kyprolis alone:

Low red blood cell counts (anemia)
Low platelet counts (thrombocytopenia)
Fatigue
Peripheral edema (swelling of the hands and feet)
Nausea
Diarrhea
Fever
Difficulty breathing/shortness of breath (dyspnea)
Cough
Headache
Cardiac Toxicities: Monitorization for signs and symptoms of cardiac failure ( when the heart muscle doesn't pump blood as well as it should) or ischemia (when the heart muscle is not getting enough blood) is recommended, such as Chest pain, Fatigue, Shortness of breath, and Swelling

The following common side effects were also reported when Kyprolis was combined with other agents:

Upper respiratory tract infection
High blood pressure (Hypertension)
Insomnia

Commonly Used With Kyprolis

Lenalidomide and dexamethasone; or
Dexamethasone; or
Daratumumab and dexamethasone; or
Daratumumab and hyaluronidase-fihj and dexamethasone

Currently Being Tested With Kyprolis

Immunomodulators (IMiDs): Thalidomide, Lenalidomide, Pomalidomide
Corticosteroids: Dexamethasone, Prednisone
Monoclonal antibodies: Daratumumab, Elotuzumab, Isatuximab, Elotuzumab
Antibody-drug conjugates: Belantamab Mafodotin
Antineoplastic agents: Cyclophosphamide, Bendamustine, Busulfan, Melphalan
Antibiotics with antineoplastic activity: Clarithromycin
BCL-2 inhibitors: Venetoclax
Selective inhibitor of nuclear export: Selinexor

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