Carfilzomib And Cardiac Events In A Single Institution Non-Caucasian Cohort.

e20039 Background: Carfilzomib (Ky) is an irreversible proteasome inhibitor. Phase III trials, ASPIRE and ENDEAVOR reported cardiovascular adverse events (CvAE) associated with Ky. We performed this study to identify the factors associated with CvAE in a non-Caucasian cohort of patients diagnosed with multiple myeloma (MM). Methods: Patients diagnosed with MM at Cook County Hospital between January 2012 and December 2017 were retrospectively evaluated. Patients treated with Ky were included in the study. Data was analyzed using Fischer’s Exact test and two tailed p-value was obtained. Results: A total of 18 patients were included in the study, out of which 50% were men, with a median age of 56.5 years. Twelve (66.7%) patients were African-American, 4 (22.2%) were Hispanic, and 2 (11.2%) were Asian. Cardiovascular (CVS) risk factors included prior cardiotoxic chemotherapy (22.3%), smoking history (44.4%), hypertension (55.6%), diabetes (16.7%), chronic kidney disease (27.8%) and coronary artery disease (22.3%) were noted. EKG abnormalities, prior to starting Ky were noted in 12 (67%) patients, left ventricular hypertrophy (LVH) being the most common finding, seen in 5 patients (27.8%). An echocardiogram (Echo) was done in 5 patients (27.8%) prior to starting Ky and showed an ejection fraction (EF) less than 50% in 2 patients (11.2%). In 10 patients (55.6%), Ky was used as second line therapy. Three patients (16.7%) patients developed CvAE, where 2 patients developed hypertensive crises (HTNC) (after 1st and 2nd cycle) and 1 patient developed heart failure with reduced EF (HFrEF) (after 3rd cycle) which led to treatment discontinuation in all 3 patients. One patient with HTNC received 20/56 mg/m2 dose and the other 2 patients received 20/27mg/m2 dose. Only LVH (p-0.0123) and ≤ 3 cycles of Ky (p-0.0123) were significantly associated with CvAE. Conclusions: Our study shows that if CvAE occurs secondary to Ky, then it would generally occur early in the treatment course in non-Caucasians. This finding is in congruence with results of Phase III ASPIRE study. In our cohort, LVH in EKG was also associated with CvAE. Our results suggest that, in a non-Caucasian cohort of patients a closer monitoring of CVS function is required at the time of initiation of Ky.