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基于达拉图马布的四重组治疗可移植的新诊断的多发性骨髓瘤,具有高细胞遗传风险

Natalie S Callander¹, Rebecca Silbermann², Jonathan L Kaufman³

¹University of Wisconsin Carbone Cancer Center, Madison, WI, USA. nsc@medicine.wisc.edu.

Blood cancer journal

|April 22, 2024

概括

含达拉图穆马布的疗法在新诊断的多发性骨髓瘤 (NDMM) 患者中具有高风险细胞遗传异常 (HRCAs) 的疗效. 虽然有益,但多个HRCAs的结果会恶化,这表明需要针对超高风险的NDMM制定新的策略.

科学领域:

血液学血液学血液学
在瘤学瘤学.
临床试验临床试验

背景情况:

新诊断的多发性骨髓瘤 (NDMM) 患者具有高风险细胞遗传异常 (HRCAs) 面临较差的预后.
单克隆抗体Daratumumab在与标准疗法相结合时改善了NDMM的结果.

研究的目的:

为了比较daratumumab加carfilzomib/lenalidomide/dexamethasone (D-KRd) 和daratumumab加lenalidomide/bortezomib/dexamethasone (D-RVd) 在具有HRCAs的可移植NDMM患者中的疗效.
评估HRCA数量对治疗反应和生存结果的影响.

主要方法:

对来自MASTER (D-KRd) 和GRIFFIN (D-RVd) 研究的数据进行了后期分析.
患者根据0,1,或≥2个HRCAs的存在进行了分层 (del(17p),t(4;14),t(14;16),t(14;20),增益/amp(1q21)).
评估的结果包括完全响应率,MRD消极性和无进展生存期 (PFS).

主要成果:

在所有HRCA亚组中,D-KRd和D-RVd的完整响应率高,但在≥2个HRCA的患者中略低.
最小残留疾病 (MRD) 的负面率通常很高,但随着越来越多的HRCAs,特别是D-RVd的数量下降.
无进展生存期 (PFS) 在≥2个HRCAs的患者中显着较低,而在两种治疗手臂中,HRCA为0或1的患者相比.

结论:

含达拉图马布的疗法 (D-KRd和D-RVd) 对具有HRCAs的可移植NDMM患者有效.
患有多重 (≥2) HRCAs的患者表现较差,突出显示了对这个超高风险子组的强化或新型治疗策略的需求.

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