To systematically evaluate the efficacy and safety of carfilzomib in treating relapsed and/or refractory multiple myeloma (RRMM) in the real world.

Relevant databases at home and abroad were searched (up to April 2023), and the literature on real-world studies of carfilzomib in the treatment of RRMM was collected. The quality of the literature was evaluated with the methodological index for non-randomized studies (MINORS) scale. Research data on the effectiveness and safety in RRMM patients treated with carfilzomib were extracted. The effectiveness indicators included the overall response rate (ORR), median progression-free survival (PFS), and overall survival (OS). The safety indicators included the incidence of adverse events (AEs) and the rate of treatment termination due to AEs, etc. Stata 13.0 software was used for meta-analysis of single proportions, and the occurrence of major adverse events was analyzed by descriptive statistics.

A total of 12 studies were entered, including 2 615 patients. The quality evaluation results showed that all of the 12 studies were with high quality. The meta-analysis of single proportions showed that ORR of carfilzomib in the treatment of RRMM was 75%[95% confidence interval (CI): 68%-82%], the incidence of ≥ grade 3 AEs was 46% (95%CI: 44%-49%), and the incidence of treatment termination due to AEs was 14% (95%CI: 10%-19%). AEs with an incidence of >5% included thrombocytopenia, anemia, neutropenia, infection, hypertension, liver injury, and kidney injury.

In the real world, the efficacy of carfilzomib in the treatment of RRMM is lower than that in clinical trials. The occurrence of infection during carfilzomib treatment and drug toxicity to the hematological system, cardiovascular system, liver, and kidney need to be paid attention to.

Multiple myeloma; Carfilzomib; Efficacy; Safety; Meta-analysis