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Efficacy of Daratumumab-Containing Regimens Among Patients With Multiple Myeloma Progressing on Lenalidomide
Hira Mian1, Christine Eisfeld2, Christopher P Venner3
1Department of Oncology, Juravinski Cancer Center, Hamilton, ON, Canada.
Background:
Daratumumab, a monoclonal antibody directed against CD38 is a recent class of drugs introduced into the multiple myeloma therapeutic landscape. While clinical trial data have shown a remarkable impact on outcomes, the efficacy of daratumumab combination therapies in specific clinically relevant subgroups including among patients refractory to lenalidomide maintenance remains unknown.
Methods:
In this study, retrospective data were reviewed from the Canadian Myeloma Research Group and the German Munster Myeloma databases to identify patients that received daratumumab in combination with pomalidomide (DPd), lenalidomide (DRd), and bortezomib (DVd) in a population that had relapsed on lenalidomide maintenance postautologous stem cell transplant. The primary aim of the study was to look at outcomes of these patients in different daratumumab combinations.
Results:
A total of 73 patients were identified. The median age of the patients at the time of daratumumab initiation was 60 (38-72) and 64.4% (n = 47) were men. In the selected cohort, 43.8% (n = 32) were treated with DRd, 31.5% (n = 23) with DVd, and 24.7% (n = 18) with DPd regimen. The median progression-free survival (PFS) of the entire cohort was 15.8 months (95% CI, 12.9-37.1 months). The median PFS of the individual regimens was as follows: DPd 18.9 months (95% CI, 13.7-not reached), DRd 21.7 months (95% CI, 11.6-not reached), and DVd 12.9 months (95% CI, 3.1-not reached).
Conclusions:
Daratumumab-containing therapies are effective regimens in patients progressing on lenalidomide maintenance. Additional studies are required to decide the optimal regimen post-lenalidomide maintenance.
Insights
Daratumumab combination therapies show efficacy in multiple myeloma patients refractory to lenalidomide maintenance. Regimens like DPd, DRd, and DVd offer significant progression-free survival, guiding future treatment strategies.
Area of Science:
- Hematology
- Oncology
- Immunotherapy
Background:
- Daratumumab, a CD38-targeting monoclonal antibody, represents a novel therapeutic option for multiple myeloma.
- Clinical trials demonstrate daratumumab's significant impact on patient outcomes.
- Efficacy data for daratumumab combinations in specific subgroups, particularly those refractory to lenalidomide maintenance, are limited.
Purpose of the Study:
- To evaluate the outcomes of daratumumab combination therapies in patients with relapsed multiple myeloma after lenalidomide maintenance.
- To compare the efficacy of different daratumumab combinations: pomalidomide (DPd), lenalidomide (DRd), and bortezomib (DVd).
Main Methods:
- Retrospective analysis of data from the Canadian Myeloma Research Group and German Munster Myeloma databases.
- Identification of patients treated with daratumumab in combination with pomalidomide, lenalidomide, or bortezomib post-lenalidomide maintenance and autologous stem cell transplant.
- Assessment of progression-free survival (PFS) as the primary outcome measure.
Main Results:
- A cohort of 73 patients was analyzed, with a median age of 60 years; 64.4% were male.
- Treatment regimens included DRd (43.8%), DVd (31.5%), and DPd (24.7%).
- The overall median PFS for the cohort was 15.8 months. Individual regimen PFS: DPd 18.9 months, DRd 21.7 months, and DVd 12.9 months.
Conclusions:
- Daratumumab-containing regimens are effective for multiple myeloma patients progressing on lenalidomide maintenance.
- Further research is needed to determine the optimal daratumumab-based regimen for post-lenalidomide maintenance therapy.
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