Daratumumab, Bortezomib, Lenalidomide, and Dexamethasone for Multiple Myeloma
In RCT (n=709), addition of subcutaneous daratumumab to VRd induction & consolidation with lenalidomide maintenance therapy (LMT), or to VRd induction & consolidation, improved progression-free survival at 48 months vs LMT alone (84.3% vs 67.7%, HR 0.42;95%CI, 0.30-0.59; P<0.001)
Source:
New England Journal of Medicine
SPS commentary:
The VRd regimen comprised bortezomib, lenalidomide, and dexamethasone.
The most common grade 3 or 4 adverse events were neutropenia (62.1% in the daratumumab arm versus 51.0%) and thrombocytopenia (29.1% versus 17.3%).
A related editorial discusses the improvements in survival and well-being for patients with multiple myeloma over the last 20 years due to therapeutic advances. It discusses the results of the current study and notes the corroboration with a phase 2 study of similar design. It concludes that when comparing first-line therapies for myeloma, overall survival is the standard outcome measure, rather than progression-free survival; these data are awaited.