A trial looking at different treatments including carfilzomib for people with myeloma (CARDAMON)

The team found that consolidation treatment did not meet the required aims and goals to be considered as a replacement for stem cell transplant. However the results were close enough that it may be a suitable treatment for certain people.   

Trial design
This was a phase 2 trial . There were 2 parts to the trial. 281 people were to have treatment as part of the trial. 

Part 1
278 people had carfilzomib, cyclophosphamide and dexamethasone as their induction treatment. 

Part 2 
This part was randomised . A computer put 218 of the 278 people who were in part 1 into a treatment group. The 2 groups were:

• 109 people had consolidation treatment 
• 109 people had a stem cell transplant

CARDAMON-randomisation.png

After their consolidation treatment or stem cell transplant everyone was to have maintenance therapy. This was carfilzomib and dexamethasone. 
 
The trial team looked at the results based on the intended treatment for these people. They weren’t looking at the actual treatment they had. This is an intention to treat analysis .

Results
The team looked at how well the induction treatment worked. They found that 162 people (57.7%) had a very good partial response. This means there was little evidence of the myeloma in their blood after treatment. 

After 2 years the team looked at how many people were alive and still free of myeloma. They found that it was:

• 68 out of every 100 people (68%) who had consolidation treatment
• 75 out of every 100 people  (75%) who had a stem cell transplant

CARDAMON-bar-chart

They also looked at the overall number of people who were still alive at 2 years. They found that it was:

• just under 91 out of every 100 people (90.8%) who had the consolidation treatment
• over 94 out of every 100 people  (94.4%) who had the stem cell transplant

CARDAMON-bar-chart-2.png

Side effects
The most common side effects people had were:

• a drop in the red blood cells and the white blood cells
• high blood pressure
• infections

Conclusion
The team say that further trials using consolidation therapy to delay having a stem cell transplant would be acceptable. Particularly for those who have little or no sign of myeloma after the induction treatment. 

A French study group is running a trial for people who have little sign of their myeloma after induction treatment. It is comparing:

• having a transplant
• consolidation therapy

More detailed information
There is more information about this research in the reference below. 

Please note, this article is not in plain English. It has been written for healthcare professionals and researchers.

Journal articles
Upfront autologous haematopoietic stem-cell transplantation versus carfilzomib–cyclophosphamide– dexamethasone consolidation with carfilzomib maintenance in patients with newly diagnosed multiple myeloma in England and Wales (CARDAMON): a randomised, phase 2, non-inferiority trial

Kwee Yong, William Wilson, Ruth M de Tute, Marquita Camilleri et al.

 Lancet Haematology  2023; 10: e93–106

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists peer reviewed  and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.