Carfilzomib
Aliases: Kyprolis
Last verified: 2026-09-23
The short version
A tetrapeptide epoxyketone — second-generation irreversible proteasome inhibitor for myeloma.
Identity & type
- Molecular type
- peptide
- Origin
- A tetrapeptide epoxyketone — second-generation irreversible proteasome inhibitor for myeloma.
Mechanism of action
Covalently binds the proteasome → longer inhibition, less neuropathy than bortezomib.
Dosing & routes
Official / clinical context
Approved drug — indications, dosing and warnings are defined by the official label. 20–56 mg/m² IV per schedule.
Regulator-approved labeling and published study designs — never a recommendation.
Community-reported practice
20–56 mg/m² IV per schedule. Kyprolis: a stronger proteasome inhibitor for relapsed myeloma; less neuropathy, more cardiac monitoring.
Unverified self-reports. Not medical advice. Not endorsement.
Expected effects (community)
Kyprolis: a stronger proteasome inhibitor for relapsed myeloma; less neuropathy, more cardiac monitoring.
Protocol — official vs community
Official / label
Kyprolis (relapsed/refractory multiple myeloma, with dexamethasone ± daratumumab): 20 mg/m² IV on days 1–2 of cycle 1 only (mandatory ramp-up), then the regimen target dose — 27 mg/m² twice-weekly or up to 56 mg/m² once-weekly — on days 1, 2, 8, 9, 15, 16 of 28-day cycles.
- 01Cycle 1, days 1–2: 20 mg/m² (first-cycle escalation for tolerability)
- 02Cycle 2 onward: escalate to the target dose (27–56 mg/m² depending on combination regimen)
- 03After any hold ≥1 week: re-escalate from 20 mg/m²
Duration: 28-day cycles continued until progression or unacceptable toxicity — commonly months to years across relapsed lines.
Cardiac, pulmonary (dyspnea) and hypertensive events cluster early in therapy, which is the entire rationale for the 20 mg/m² ramp. Hydration and dexamethasone premedication are built into the schedule.
Community (anecdotal)
Structured protocol data for this entry is coming.
Human evidence
Approved 2012; ASPIRE/ENDEAVOR trials.
Preclinical evidence
The preclinical phase was completed and submitted to regulators as part of registration; pharmacology and toxicology details are part of the official label.
Known risks
- Cardiotoxicity, dyspnea, hypertension.characterized
Teal: characterized in clinical/labeling contexts. Amber: theoretical or reported outside controlled settings.
Unknowns & evidence gaps
- Real-world data outside controlled trials