Would you substitute carfilzomib in place of bortezomib in a transplant-eligible AL amyloidosis patient with baseline amyloid neuropathy and worsening neuropathy on bortezomib despite maximal dose reduction?

I never give carfilzomib as part of first line therapy on Al amyloidosis. These patients already have some form of cardiac involvement (based on troponin and NT proBNP). 56% of AL amyloid patients have 2 or more organ involvements with cardiac being one of them. Always take into consideration cardia...

For patients on a bortezomib-based regimen (let's say Dara-CyBorD) for AL amyloidosis but developing disabling neuropathy, I agree with @Dr. First Last about not jumping next to carfilzomib. I think the most important aspect is what is the patient's disease response. If they're already in a CR, then...