Combined with lenalidomide and dexamethasone, carfilzomib achieves a near complete clinical response in naive MM patients.477 In patients with relapsed/refractory MM, carfilzomib and dexamethasone (Kd56) demonstrate a longer PFS than that of bortezomib and dexamethasone (Vd).478 Panobinostat, an HDAC inhibitor, is also used with carfilzomib in MM patients and achieves a good response rate (ClinicalTrial.gov: NCT01549431).359. This evidence concerns the gene HDAC9 and Miyoshi myopathy.