학술논문
Daratumumab-based quadruplet therapy for transplant-eligible newly diagnosed multiple myeloma with high cytogenetic risk.
Document Type
article
Author
Callander, Natalie; Silbermann, Rebecca; Kaufman, Jonathan; Godby, Kelly; Laubach, Jacob; Schmidt, Timothy; Sborov, Douglas; Medvedova, Eva; Reeves, Brandi; Dhakal, Binod; Rodriguez, Cesar; Chhabra, Saurabh; Bal, Susan; Anderson, Larry; Dholaria, Bhagirathbhai; Nathwani, Nitya; Hari, Parameswaran; Shah, Nina; Bumma, Naresh; Holstein, Sarah; Costello, Caitlin; Jakubowiak, Andrzej; Wildes, Tanya; Orlowski, Robert; Shain, Kenneth; Cowan, Andrew; Pei, Huiling; Cortoos, Annelore; Patel, Sharmila; Lin, Thomas; Giri, Smith; Costa, Luciano; Usmani, Saad; Richardson, Paul; Voorhees, Peter; Chari, Ajai
Source
Blood Cancer Journal. 14(1)
Subject
Language
Abstract
In the MASTER study (NCT03224507), daratumumab+carfilzomib/lenalidomide/dexamethasone (D-KRd) demonstrated promising efficacy in transplant-eligible newly diagnosed multiple myeloma (NDMM). In GRIFFIN (NCT02874742), daratumumab+lenalidomide/bortezomib/dexamethasone (D-RVd) improved outcomes for transplant-eligible NDMM. Here, we present a post hoc analysis of patients with high-risk cytogenetic abnormalities (HRCAs; del[17p], t[4;14], t[14;16], t[14;20], or gain/amp[1q21]). Among 123 D-KRd patients, 43.1%, 37.4%, and 19.5% had 0, 1, or ≥2 HRCAs. Among 120 D-RVd patients, 55.8%, 28.3%, and 10.8% had 0, 1, or ≥2 HRCAs. Rates of complete response or better (best on study) for 0, 1, or ≥2 HRCAs were 90.6%, 89.1%, and 70.8% for D-KRd, and 90.9%, 78.8%, and 61.5% for D-RVd. At median follow-up (MASTER, 31.1 months; GRIFFIN, 49.6 months for randomized patients/59.5 months for safety run-in patients), MRD-negativity rates as assessed by next-generation sequencing (10-5) were 80.0%, 86.4%, and 83.3% for 0, 1, or ≥2 HRCAs for D-KRd, and 76.1%, 55.9%, and 61.5% for D-RVd. PFS was similar between studies and superior for 0 or 1 versus ≥2 HRCAs: 36-month PFS rates for D-KRd were 89.9%, 86.2%, and 52.4%, and 96.7%, 90.5%, and 53.5% for D-RVd. These data support the use of daratumumab-containing regimens for transplant-eligible NDMM with HCRAs; however, additional strategies are needed for ultra-high-risk disease (≥2 HRCAs). Video Abstract.